Hi, @katgirl You are asking a great question. I suggest watching this video by Michael Lavacot for an introduction to the different drug options.
https://m.youtube.com/watch?v=Z4uXAsnhSaA
I’m also attaching an OsteoBoston video with Benjamin Leder which I found to be helpful when I was first navigating my diagnosis.
https://m.youtube.com/watch?v=pV5maUhAjOA
The order in which we take osteoporosis drugs matters. Evenity, Tymlos, and Forteo are all anabolics that build bone, and they are most effective prior to treatment with an antiresorptive like reclast. The videos I’ve included will provide good information on this, and you can find more information using search terms: osteoporosis treatment sequence.

@katgirl it helps to see an endocrinologist. Was it a primary care doctor who prescribed Reclast? Insurance companies persist in covering Reclast (and Fosamax) and Prolia as front line because they are cheaper, when it is better to start with an anabolic like Forteo or Tymlos, or start with Evenity (which is anabolic at first and then more anti-resorptive).

Reclast will reduce the effectiveness of anabolics to some extent so that is why the sequence of anabolic first is important. Also, Reclast is limited ideally to 3-5 years. If you do do an anabolic, you will need Reclast afterwards to "lock in gains." Furthermore, getting off Prolia requires Reclast to avoid rebound loss of bone density and increase in fractures. As you can see, you can run out of time for Reclast.

If your are borderline or have very mild osteoporosis the course might be different and you could even consider natural approaches. If your DEXA scores are concerning, I would cancel the Reclast and try to get on an anabolic. That's me- I am just another patient- so consult with an endo.

Forteo and Tymlos work through the parathyroid. Evenity works by inhibiting sclerostin. People born with low sclerostin have very thick bones which gave researchers the idea.

I like Ben Leder's videos (he has one on OsteoBoston and another one entitlted "Combination and Sequential Approaches to Osteoporosis"). The other resource many of us use is Keith McCormick's "Great Bones," a 700 page book useful for reference that includes both meds and holistic methods. McCormick also does consultation. He is a chiropractor specializing in osteoporosis. His website is osteonaturals.com.

My story was very similar to yours. Diagnosed at 57 (had to convince doc to prescribe dexa), referred to an endocrinologist who said I needed Reclast. I also am very susceptible to drug side effects. Doc didn't really discuss any other options, I was sleep deprived and freaked out and it takes me awhile to process information so I didn't really know what questions to ask. After some grief and a lot of reading I decided to take a step back. Changed diet, gained weight, started weight lifting and balance training. Took a year of talking to various doctors until I found a specialist and decided on HRT instead of osteo meds. I was a bit worried about that too as I am 8 years past menopause. But I feel a lot better, wish someone had told me about hormones earlier. Next dexa in March, we'll see. Good luck to you!