I was diagnosed with osteopenia at age 53. Spine was -1.3 and hip was -2. I continued with HRT and weight training (both started at age 51). I was on a healthy diet at the time (lean meat, fish, veggies, fruits with minimal carbs) so I continued that. I also added a 1:1 calcium/magnesium supplement, Vit D, and Vit K.

My BMD continued to decline until I hit -2 in my spine and -2.8 in my hip. I hadn't done a lot of research on meds up until that point, only lifestyle. My PCP started me on Fosamax and I thought that was reasonable since my BMD was continuing to decline even with a healthy lifestyle.

Initial results were very good, with my spine at -1.5 after two years. However, my hips remained about the same.

After 5 years on Fosamax, I had a fragility fracture bending over a bathtub and pressing down hard on my ribcage. It was a partial compression (~15%) of T8 and it had a huge impact on my life. I would do anything to avoid another.

I stopped the Fosamax and was started on Tymlos then Forteo (generic). I had to switch to Forteo after my insurance revoked my pre-auth. Unfortunately, the Forteo just didn't work out for me.

At that point, I sought a referral to an endocrinologist at a metabolic bone disease clinic and she has been amazing. She tested me for many more issues than my previous rheumatologist. She wasn't able to find an underlying issue contributing to my osteoporosis but thinks there is a genetic predisposition as my dad had similar issues.

I started on Evenity a few weeks ago and have had no side effects. I am very happy with treatment at this point and hopeful that the Evenity will help prevent another fracture. I trust this doctor.

My point of this long post is to say that each of us is different and there is definitely no one size fits all treatment. It can take time to find the right approach but I would say to keep an open mind and don't dismiss the meds. Most of all, you want to avoid a fracture because it's terribly life-impacting. Good luck!