Tymlos took me from -3.7 to -2.5 in lumbar spine. I had trouble with the full dose at first so I did 1/4 dose (20mcg) and moved up slowly. The pen has adjustable dosing. You may not need to do this but if you are nervous, try starting at a half dose for a couple of days. Many of us have found that no matter how we start, the initial side effects ease up in a week or two.

I personally think it is great that you are starting at -3.2, before things get really bad. COVID delayed my starting and I had a few painful fractures that have left me with some disability. Good luck!