heyjoe415, these same questions have been asked since they started treating osteoporosis in the late 1990s. We're all late. It is interesting to look back to 2014 and find the same questions and some excellent timeproof answers.
All the medication are very dangerous for some, completely safe for others. For most these drugs are inconvenient, uncomfortable and very much better than fractures.
Here is my very biased opinion:
There are basically two types of osteoporosis drugs--those that build bone and those that stop bone from breaking down.
All the bisphosphonates stop the normal process of bone renewal by stopping the initiating process of breaking the bone down. The stop the osteoclasts--the acid producing cells that remove fissured bone and initiate the production of osteoblasts--the cells that lay down new bone. They prevent fracture by collecting older bone. Osteoclasts are part of the immune system, so people with autoimmune disease are more likely to have side effects. In 1995 they were approved by the FDA. They were basically the only thing we had to slow the breaking of our bones until November 6, 2002.

The FDA approved the second type of medication the anabolic Forteo--my absolute favorite. It emulates the normal manner of bone building with and analog of parathyroid hormone. It pulls calcium from your bone telling your body to produce osteoclasts and osteoblasts and get busy repairing bone. In 2017 FDA approved a newer (perhaps better) version of the parathyroid analog-- Tymlos. My second favorite medication. Some people cannot tolerate either of these medications.

I'll give short shrift to the two following medications Prolia and Evenity. I don't like the mechanism of action of either drugs. And can't be trusted to give fair assessment.
Prolia was originally considered antiresporptive like the bisphosphonates and Eventiy was considered anabolic.
Each medication is actually both antiresorptive and anabolic.
Anabolic in a different way. They don't build normal bone. The new bone is modeled bone. It is more like a scaffold deposited on the outer most portion of the bone. Bone Mineral Density is usually intense with both medications over a short period of time. They both can prevent fractures, which is the goal. I don't care when they were approved and even think that they should not have been approved.
Prolia stops the production of osteoclasts efficiently but does so by stopping them in a late stage of development. When you stop Prolia you have to take another antiresorptive to protect bones against an avalanche of collected osteoclasts that can cause cascade fractures.
Evenity has a black box warning for cardiac issues. Since most of will die of heart disease the drug falls out of consideration for me. But real world experience may prove the black box to be overcautious. Still it produces modeled bone that is thick and lack the cannulation that gives bone integrity and strength.
Most of what I've written is highly biased, and must be questioned during your quest for the best osteoporosis medication for yourself.
This post is intended to excite opposing opinion to give your the full spectrum of views.
Thank you for your empathy, Joe and welcome to Connect.