Going to Dr. today to discuss starting on medication.

petra31, you might ask about starting with an antiresorptive. I'd ask abotTymlos for the hips. Prolia is an antiresorptive and can be difficult to go off of without losing bone. And it is considered preferable to begin with a medication that builds bone. Prolia is the easiest for you bone clinic to prescribe.
You probably know that Prolia increases bone density by collecting older bone. It really stops the remodeling process that make our bone less susceptible to fracture.
Like me you are probably stuck on this earth for at least 30 more years. That's way to long to be on Prolia. After 3 to 5 years you have to take another drug to prevent fractures that are caused by the very mechanism that makes Prolia effective. Some people get trapped on Prolia because they can't tolerate other medications or because other medications are not effective. The best drugs (Forteo and Tymlos) are not effective after Prolia. So you are stuck with Evenity or a bisphosphonate.
Whatever you decide you might want to request bone markers P1Np and CTX to ascertain that the medication is effective.
I hope you have an interesting appointment. Be sure and come back and reveal everything you find out.

I think you may want to consider what @gently has posted. I am 70, started an oral alendronate at 67, couldn’t tolerate it (stomach issues and conjunctivitis) and switched to Reclast. I was in mild osteoporosis and now am at osteopenia. While that has worked for me, you have a different family profile.

My mom had osteoporosis but never a broken bone. She had fallen 3x before going into assisted living and had not broken anything. Her mother, my great grandmother, lived to 100. My mom passed away at 92 it would have lived longer with better care. My two older sisters have also been treated, 5 years each, for osteopenia - never osteoporosis. They have never broken a hip, neither of them had spine fractures. One sister did break her wrist, but the type of fall she had would have broken anyone’s wrist.

With a family history of hip replacement, you’ll want to consider your own health as compared to your mom. Perhaps because of lifestyle choices you aren’t headed down that road? But if it’s a possibility, you might want something more like a bone builder.

Doctors usually start with something like Prolia or alendronate but I believe that is because insurance companies have their hands tied. They may not pay for a direct route to a bone builder. But if your doctor does agree that a bone builder would be beneficial then a well written request to the insurance company might include your mothers hip replacements, your life expectancy, your age - in that your will lose precious time messing around with Prolia and probably costing the insurance company MUCH more by the later treatments you might need. And, what every insurance fears, that you will be some incapacitated and require nursing care (very expensive). It’s unfortunate that insurance companies use actuarial tables to figure life expectancy and at 70 we are expected to only live 15.72 more years. That is a number they use in figuring out whether they will pay for treatment. They have a tough time approving treatments that will carry us through age 100, when they think we’ll be gone at 82. Sad, but true.
We just have to convince them to look at each of us as individuals - and you’re going to be here until 100 they better keep you healthy for a loooong time! It saves them money.

Thanks so much for your comments and information, much appreciated. I just got a script from my Dr. for oral alendronate; she felt it was best to start with it and, if I have problems, it doesn't stay in your system too long and we can look at other options. My insurance pays for this, no problem there. I will look into your comments about a bone builder if this script doesn't work. (sensitive stomach issues here). The actuarial tables are very interesting, I didn't consider this at first but, in taking care of my mother for so many years, am not surprised that they consider life expectancy this way--perhaps hubris on my part, as we never know the future, but I hope to live beyond that extra 15.73 years! My mother beat so many actuarial tables, including living 2 years in hospice care until 100 and 2 months old. Who can ever predict the future, we can only plan for it the best way with support and good information.

thank you, "gently" I appreciate your support and information. I didn't know about requesting bone markers PINp and CTX, but will certainly keep that in mind. I actually went back to my primary Dr., who I've had for 25 plus years. We are the same age, she is so competent and emphatic, I felt better going to her rather than going back to the Bone Clinic. I'll try the oral alendronate she recommended today and see if I can tolerate it. "Rubyslippers" had some great suggestions and comments as well. Happy to find this group! (procrastination is a big problem, should have started a year ago).

Interesting, I am in a similar situation but only 64 … so, which meds build bone again?

I think it's incorrect to say that Alendronate doesn't stay in your system for too long because the drug has a half-life of over 10 years within bone tissues.

Once you're on the drug, please comment on whether you had any side effects. My dr has suggested I take this drug but I'm afraid after reading about all the side effects.

I’m going to let someone else answer your question. I only know what I’ve taken, alendronate and Reclast. It would be best to hear from more experienced users of bone builders!

@suzieqqqqq, hi.
the short slippery answer from me would be Forteo and Tymlos.
There are anabolics and antiresorptives.
Anabolics tymlos and forteo build bone by increasing the activity of cells that actually lay down bone.
Antiresorptives prevent the process of rebuilding bone by stopping the cells that break bone down. A process necessary for the remodeling process. Antiresorptives add bone density by accretion. So your bones are collecting older fissured bone. These drugs are all the bisphosphonates; Reclast, Alendronate, Fosamax. And Prolia which has a different mechanism for the same antiresorptive effect.
Finally there is Evenity which is considered to be anabolic initially and antiresorptive after several months of use.
The antiresorptives do prevent fractures. Bisphosphonates have been the only mainstay against fracture, until the advent of Forteo twenty plus years ago.
In my unschooled opinion Forteo is the finest pharmaceutical. It builds the best bone the fastest.
There are people who cannot tolerate Forteo. And others for whom Forteo is not a bone building medication. Which med builds bone depends on secondary causes, kidney function and immune status.

Thank you; I appreciate the specificity and info!!

Please look at the natural ways to increase density. Don’t do Prolia or any of the biphosphonates!!! My doctor told me no on Prolia saying if you start it you have to do it the rest of your life because if you get off within short time your bones will literally collapse. I’ve seen several incidences where this proved true. Very scary. I would never even think about it. I’m 78 just got over three burst compression fractures from
A fall backwards on driveway. Fractured my skull also. But I’m doing well. No drugs. Walking about 10 miles per month on treadmill to strengthen muscles. Was released January 2024. No issues since. I lost three inches and have hard time holding head up straight but doing much better. Use a walker a lot. But glad to be pain free.