I started the HRT first, right after the diagnosis of osteoporosis, because I was able to order it for myself. It took awhile to get in with the endocrinologist, but the next labs I'll do for her have some bone markers. She did a lot of labs initially checking for adult-onset bone conditions, checked the parathyroid glands, and all that.

I have recovered well from the fracture, and will start skiing again, since this last DEXA is so improved.

As an example of why I think Covid infections caused bone loss: in 2015 I went over the handlebars of my mountain bike and dropped about 10 feet onto hard-packed dirt and granite. My pelvis was fractured in two places. It was quite an impact, and the orthopedist joked that I had given myself a DEXA scan, because if I had osteoporosis, my pelvis would have shattered! It didn't, because I didn't at that point. I spent 3 weeks on crutches, then walked away as if it had never happened.
The only thing that happened between that accident and my spinal fragility fracture was 4 cases of Covid. Almost impossible to avoid as a working MD. Covid, even minor infections, has been shown to cause rapid bone loss in lab rats set up to mimic humans as closely as possible. In light of that first accident, I was stunned to receive the osteoporosis diagnosis.