Dear @debbie1956, @mayblin , and @newenglandtransplant. Thank you so very much for your kind, thorough, and thoughtful responses!

Debbie1956,
Great idea to consider working with a naturopath and especially certified by NA Menopause Society - I had not thought of that and will look into it.
Indeed, I have learned how BHRT transdermal and micronized progesterone can be safe tho have risk of blood clots.
Also helpful to be reminded to ensure I include a plan for the appropriate frequency and type of testing such as lipid panel, CTX - turnover/resorption, coronary artery, vitamin d, ++.
Sorry to hear you had a vasculitis autoimmune condition and needed Prednisone - can only imagine the side effects and impact on bone integrity.
I also have only been learning about the REMS Echolight test so need to ask about that.
So incredibly frustrating to think that you could have avoided so much trauma and the same for me if the WHI study had not mislead a whole generation.

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Newenglandtransplant, just a quick note - my mom had invasive lobular breast cancer. I am very glad your regimen includes bi-annual MRI and Mammogram screenings. please consider adding, if you don't already, always telling the technicians about your LCIS. My mom's gyn detected the tumor during a routine annual breast exam. It turned out this had been evident on mammograms in at least one prior year, but had been overlooked. By then, the tumor was stage 4. I recently read an article reminding that technicians and radiologists have varying skill levels and and moments of attentiveness (like anyone) and supervising radiologists can sometimes sign off without checking the scans. I know this sounds paranoid, but we were told later that "lobular masses are difficult to see on scans." Maybe the doctors were just trying to protect the radiologist from litigation (which we did not pursue for many reasons). Just please be extra vigilant.

I am now seeking new providers, will look for a breast clinic, and will ask about anabolic/bone forming medications. My lowest dexa score is -3.3 so I don't see why my endocrinologist was so ready to just have me wait and see, only ensuring osteo-specific exercise and vitamins.

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Mayblin, thank you for sharing the study - extremely helpful. Such a reassuring statement: "A thorough literature review affirms that, in postmenopausal women, estradiol (E2) effectively relieves vasomotor symptoms and symptoms associated with the genitourinary syndrome of menopause, that is, vulvovaginal atrophy symptoms, while maintaining bone mineral density. The evidence also supports that estrogen–E2 is associated with decreased breast cancer and cardiovascular mortality."

I will definitely look into and ask about Evista (raloxifene).

I keep seeing references to "prior history of cancer and/or breast cancer or family history of either" often negates candidacy for HRT, and I know there a studies showing increased likelihood of recurrence, but I have not yet come across a study showing use of the newer forms of HRT and increased incidence of breast cancer. It certainly makes sense to consider this, I just would like to see more data so will keep looking.

I do understand that my primary focus of treating Osteoporosis is not aligned with the current prescriptions of HRT. I just want to try to avoid missing out on something that could at least maintain my bone density/integrity while also boosting the many other organs and systems that so heavily relied on hormones pre-menopause.

Thank you again to all three of you and I will stay involved here to share updates and see if I can help support in any way.

All the best for now!