I have a link for treatment guidelines compiled by NOF (National Osteoporosis Foundation), see slide page#18:
https://cme.nof.org/sites/default/files/Osteoporosis%20Guidelines%20and%20Clinical%20Practice-%20Singer.pdf
There are other guidelines available, which are generally similar, with some variation.

Each endocrinologist may recommend different pharmaceutical treatments based on his/her own clinical experience and judgement. This often leaves us patients with the decision of whether to follow our doctor's recommendation or to wait and consider other options.

Your calculated FRAX falls roughly in the middle range. For comparison, my FRAX was better than yours but my Lspine Tscore was lower at -3.4, so I decided to start Forteo shortly after diagnosis.

Given your endo's initial proposal, personally I'd choose Forteo (or Tymlos) in a heartbeat. You've probably read that sequencing matters (shown in the link). The timing of when to begin the pharmaceuticals also matter, and that decision is very personal.

I'm curious what led your endo to choose Fosamax. Would you mind sharing your baseline uNTX if you have it, and your lab's reference range for uNTX?

Based on the info I received from my two obgyns at different hospital systems, transdermal estradiol patch and micronized progesterone (both bioidentical) are generally considered safer than oral estrogen and synthetic progestins. This combination is favored by many doctors so it's worth exploring with your physician.

If Forteo (or Tymlos) ends up being your treatment choice, it's also worth discussing with your endo whether to use HRT concurrently.