@mayblin Thanks so much for reaching out! My original post was last May 2024. I'm now about to start month 15 of Tymlos. I have seen 2 more endos since last May. In Sep the endo I saw just encouraged me to stay the course and was proposing bisphosphonates after I'm done with Tymlos. Hard no to HRT because of all the negative side effects associated with them....despite those being repeatedly refuted by current research. Plus I'm well more than 10 years past menopause. More like 20. No dexa at that visit, but my blood calcium levels were 11.1 and cholesterol had also risen again. Both of those levels were never out of whack until Tymlos.

In Jan 2025 I saw another endo at a the University of Iowa, about an hour from home, who only sees osteoporosis patients. She is supposed to be the "guru" of all things osteo. Same story with her. Stay the course and recommended Prolia after year 2 of Tymlos. I did have a dexa scan this visit and my Lumbar score improved from -3.6 to -3.2 from my first dexa in 2023. No hip score or cervical score because she "doesn't do those as they really don't matter." Also the calcium score was down some to a 10.6. Cholesterol was at a mind blowing 280. Another hard no to HRT or even considering it, same reasoning. This time I pushed back a little and asked about bioidentical HRT and also asked about her thoughts on the current research discounting all the bad press around HRT from a faulty study. She said exactly this, "No, no. It makes no difference what or where the estrogen in the HRT is made. Everyone's body reacts to estrogen the same. It is all processed the same way."

I was crushed....and disappointed that the supposed guru was so very set in her thinking. I'm not going to take Prolia. That is my hard no to the next step after Tymlos. I'm now trying to find a cardiologist to check out why my cholesterol is so elevated, getting a screening for arteries to see if there really is any blockage. If there is any that may prevent anyone from prescribing HRT. Then trying to find a doc who will prescribe is nearly impossible here. I live in a rural area where health care from functional, integrative and naturopaths are hard to find. Also on the search again for yet another endo. I do have a rheumatologist who is a hard no on HRT because her mother took it and ended up with breast cancer. No reason to push her on the subject as she has personal reasons for opposing.

The quest continues. I still have a handful of months left and I may just give myself a drug holiday of my own if I keep running into "hard no" answers! Take care,
Nonna