@gravity3 I'm toying with the idea that alternating anabolics and bisphosphonates might negate the ill effects of long term bisphosphonates. So, bisphosphonates slow down bone remodeling and they help prevent fractures for awhile but eventually less remodeling leads to unhealthy bone. Anabolics boost bone remodeling. I don't understand the details but there are studies showing that Evenity in particular is not just increasing bone density willy nilly but doing so in a way that is beneficial to bone architecture. I would expect that bioidentical hormones might also be a possibility but a less powerful one than Evenity?
This is a lot of speculation on my part. Just trying out possibilities in my mind for the dilemma of how to proceed after a successful round of Evenity and not liking the standard Prolia or Reclast offerings.
BTW, I just finished Evenity and am about to start on Risedronate. Plan is 1 year on Risedronate to hopefully hold on to my Evenity gains and then back to Evenity to build more bone. If all that works according to plan I would be in good shape bone wise but have the same problem we are discussing. How to keep what you've gained for the rest of your life?