@susanew I received Reclast one-time IV infusion 10 years ago (2016) at age 60 when my Dexa showed a spinal T score of -1.6 and the hip T score of -0.6, which put me in osteopenia even though the hip T score was very good. That same year, I had two dental implants for missing molars. I was very scared, but No sideeffects happened. I am a very active and healthy eater . I tried to get my calcium 12000 mg/day from diet, and was taking a vitamin D 1000 IU supplement, MK7 K2 supplement. My last 2 Dexa in pat 10 years were borderline osteopenia. No treatment was recommended. Recently (3 months ago), I sustained a spinal T11 vertebra compression fracture; the DEXA score at the time of the fracture was in osteopenia level, and all my labs, including bone markers, are in normal range. I believe I sustained a fracture due to a combination of a stressful job, short sleep, and my wrong movement on the new trampoline. Nonetheless, my diagnosis turned to a fragility fracture osteoporosis because of the fracture. Getting an endocrinology appointment is a pain in the ... very long waiting time. Currently, I am going through clearance from the dentist after the non-fused implant removal, cardiologist for CT cardiac calcium score 47, which means some plaques in my arteries, and GI doctor for peptic ulcer ablation 7 years ago and post-ablation GERD. All new drug as Evenity, Tymlos, and Forteo, have high results in bone building (osteoblast formation), but these drugs work for a short duration after which someone needs to be on other drugs to keep that built bone, and they come with their own scary side effects. This means all these drugs work as "a short-term bandage," without providing a long-term solution. I discussed with a gynecologist experienced in menopous&osteoporosis if HRT is a choice for women 10+ years after menopause in combination with calcium, collagen, vitamin D, K2 diet and supplements, progressive strength training seems a natural way to protect our bones without fracture. I am waiting for an endocrinologist consultation and have not started my bone treatment yet, but sharing my thoughts.