If you can't tolerate oral bisphosphonates, then available IV forms are reclast (every 1-2 years, endo makes the call) or boniva (every 3mo). Reclast is a lot stronger than boniva.
The following is an excerpt from a review paper on bisphosphonates, if you are concerned about the association of their use and potential OsteoNecrosis of the Jaw:
"Whereas the incidence of ONJ is estimated to be 1 to 10 per 100 oncology patients, the risk of ONJ appears to be substantially lower among patients receiving oral bisphosphonate therapy for osteoporosis, with an estimated incidence of approximately 1 in 10,000 to 1 in 100,000 patient treatment years, although this estimate is based on incomplete data.114 Associated risk factors appear to be poor oral hygiene, a history of dental procedures or denture use, and prolonged exposure to high IV bisphosphonate doses.115,116 Whether concomitant chemotherapy or glucocorticoid use leads to an increased risk of ONJ is unknown.117 Once established, care for ONJ is largely supportive, with antiseptic oral rinses, antibiotics, and limited surgical debridement as necessary leading to healing in most cases.118 Although evidence-based guidelines at this time have not been established for any single malignancy or bisphosphonate, careful attention to dental hygiene including an oral cavity examination for active or anticipated dental issues, both before bisphosphonate initiation and throughout treatment, is likely to be paramount."
Basically the risk is very low if you just start out with a bisphosphonate for osteoporosis (not with a high dose and/or higher frequency as in oncological use). Of course double check with a dentist or an oral surgeon. Hope this is somewhat helpful.
This article completely ended my worry about ONJ as I see my dentist every 3 to 6 months. I’m passing this on to him as well..
even with a 21% increase in bone density in my spine , my T score is -1.9. I’m wondering if the Boniva will hold my gains( assuming I haven’t lost ground by not having medication for a month and 1/2)
Thank you for all your help..