I discussed this with an endocrinologist and osteoporosis md. Both said the same thing. You will get no improvement in bone density. It might hold what you have for awhile. Prolia for me was very successful. I went from severe osteoporosis at age 57 to barely osteopenia in 4 years. But after 12 years on it I started breaking bones again. Both doctors said the side effects of HRT will outweigh the small benefit. So I will go back to oral Fosamax and keep up weight bearing exercise. I cannot do Evenity or Reclast- trued and horrible side effects.