The horrible side effects means it has something to work on in your body. It means your immune system is ramping up and effectively doing something that is why I didn’t jump ship and when I was offered the other medication‘s, I looked them up and they weren’t as good so I decided to suck it up and Stay on the TMLOS. You are lumping all the medication‘s into one box. Maybe that’s all you have time for, but it would be better. If you lucked up all the medicines individually most people do not realize how different they actually are my dentist. lumped lump TYMLOS with the biphosphonates. And it is not! I hope you will stick with the TYMLOS until you get rid of the headaches. They go away. You can titrate up meaning start at two clicks and work your way up to eight it’s gentler that way some people stay on a partial dose the whole time, the medicine I am on the TYMLOS is only for two years and then I do a Reclast infusion once a year for three years and then I’m done for life. I went into menopause early at 47. I was on bio identical hormones for 10 years. I might start up again. I’m looking for a hormone specialist because my endocrinologist won’t deal with it I think your idea to use the HRT is a good one! I think you should work with the doctor or a specialist to get the testing all of it – the DEXA, the PNP, the CXT and monitor your bone density as you age. The side effects go away for most of us after two months you know what they say - no pain no gain. my life changed when the surgeon opened up my neck and the bones were paper. Thin and C5 fell apart. It meant they couldn’t do the cervical spine surgery as we had all hoped. I had done all the testing, but there are things which can’t be determined and you just gotta deal with it when it shows up, the bones in my forearm are strong and show no weakness. However, the bones that are in my neck aren’t worth shit. The bones in my lumbar were just fine when they did the surgery six years ago, so you never know. I’d rather be safe than sorry. That is why I’m putting up with the medication , I read all the reports and the reports now confirm all the testing that was done in 2017. There’s a lot of information here. I hope you get to it because many of us have asked these questions before and they’ve been answered by other members and there’s great information here. Good luck .