sgmlt2,
I waited until I was osteoporotic, even though it is said that more women fracture in osteopenia.
Factors to weigh are age, as in hormone status; activity: type and level; and balance issues.
Did you get a frax risk and/or TBS reading with the imaging.
Osteopenia with a T score of -2.4 would suggest a close look at the medications.
Most of us have osteoporosis because of hormone loss. If you were beginning peak years of loss 50 to 62 you'd be in advancing danger.
I'm not fond of the way bisphosphonates work, and they are often the drugs we are offered in osteopenia.
If you fracture because of the decision to avoid the medication, the pain and loss of function will be difficult to reconcile.
It is easier to prevent loss than to regain bone.
If you decide to take medication, you still have do all the other things that are considered alternative.