I was diagnosed with osteopenia at age 53. I was already on HRT at the time so I continued with it but added calcium and Vitamin D supplements. My doctor wanted me to see a rheumatologist at the time but my insurer refused to approve the referral.

I was very fit and active at the time, doing boot camp-style exercise with weights, running, jumping jacks, etc. I continued with a DEXA every 2 years that showed progressive bone loss in my left hip every time while my spine remained stable around -1.5. In 2018, I had slipped into osteoporosis in my hip and I was started on oral alendronate and told I would be on it for five years.

I was very complacent about the diagnosis and didn't do a lot of research other than being aware of the risk of esophageal issues when taking the med so I was careful to follow the instructions. I never thought of my osteoporosis diagnosis. My first DEXA after starting alendronate showed improvement in both my spine and my hip so I thought all was well.

I was told I would be taken off alendronate after five years and assumed that meant no more drugs for life - woo hoo!

I'm afraid I was very much in the dark about the disease.

Just after my five year anniversary on alendronate as I was getting ready to schedule an appt with my PCP to ask about coming off it, I had a compression fracture at T8. I didn't even suspect it was a fracture at the time and thought it was a pulled muscle/muscle spasm as I've suffered those from time to time. It took me four months to see the doctor and I was in complete shock when the x-ray report came back.

My lumbar T-score was -1.6.

Clearly, I wasn't completely understanding the disease because how could I have fractured on a medication that was supposed to keep me from that and improve my bone density?

A year in from my diagnosis I have learned so much about this disease but the biggest takeaways are that everyone is different, medication may be necessary, and a holistic approach is required that includes nutrition and exercise, and possibly supplements and medication.

It hasn't been a smooth road for me. The good news is that I haven't fractured again which is very common within the 12 months after your first fracture. I have recovered from the fracture and am very close to my former lifestyle.

The bad news is that I've tried both Tymlos and Forteo but have had side effects that have prevented me from continuing with them. I do have about six months total of anabolic therapy so hopefully that's helped.

The other issue is that because I was on alendronate for so long, the bone building effect of both of those meds may be diminished.

I see an endocrinologist in April for specific guidance on what's next. I would love a non-med approach but I am no longer sure that's possible.

This was long but my point is that there is no right answer to whether meds are required. You are going to have figure that out for yourself with the help of a specialist and your own research. Just be careful about people making claims either way. Good luck!