Thank you, @goseve.

There are two small clinical studies that examined the use of teriparatide (the active ingredient in Forteo) in combination with HRT. In one of the studies, participants continued HRT alone for one year after stopping teriparatide, and their bone density remained stable. It's worth noting though, that the treatment dosing regimens in those studies differed from yours - you'll be using 20 mcg of teriparatide along with a 0.075 mg estradiol patch - so the findings cannot be directly applied to your situation. I'd be happy to share links to the studies if you're interested in reading them.

Given your bilateral hip replacements, your managing physician will likely need to consider not only your overall bone strength but also the long-term stability of the bone surrounding the implants.

If you decide to rely on HRT alone for skeletal protection after Forteo, I think it’s good idea to discuss this plan with your doctors early on; whether the approach is appropriate for your situation, how best to monitor the maintenance of your Forteo gains (such as with DXA scans and possibly bone turnover markers), and what backup options might be available if additional treatment becomes necessary.

Good luck on your journey, and please keep us posted on your progress.