@marley169 , I’m also 62 and was diagnosed with osteoporosis about 15 years ago. At the time, they put me on bisphosphenates, a decision I now regret, or at least I regret having gone on them without doing a lot of my own research first. So it’s great that you are asking questions and considering options before making a choice.

Everyone is different. And so is everyone’s health profile. What I would do today if I faced your set of DXA numbers is to first find a doc who is collaborative and open to working through the pros and cons of different approaches with me. Then I’d start with diet (adequate calcium, vitamin D, vitamin K2 and magnesium as much through diet a possible) and exercise ( supervised strength training along the lines of the LIFTMOR study), and I’d look into whether menopausal hormone replacement therapy would be a good fit. (I’m on that now and wish I’d started years ago as my first step.)

I’d try that for a year or two and see what happens before starting meds. If I were still losing bone, then I’d consider meds.

These decisions are best made working with a doc who you trust based on your own specific profile.

There usually isn’t a huge rush to making a decision, so do your research. Lots of good info in this forum. Another good place for info is OsteoBoston’s website. They gather some really good speakers. Dr Keith McCormick’s book Great Bones is a great resource for detailed understanding of osteoporosis.

Good luck and wishing you the best!