Femoral neck -2.8: Would you start treatment now?

From Osteopenia to Osteoporosis in Five Years - what would you do?
Hi everyone, I'm 57 and was recently diagnosed with osteoporosis after progressing from osteopenia over the last five years.
My 2026 DXA results are:
Left femoral neck: T-score -2.8 (osteoporosis)
Right femoral neck: T-score -2.3
Total hips: -1.7 and -1.9
Lumbar spine average: -1.2 (although I'm investigating whether this may be masking more significant bone loss, as L4 alone is -2.2)
My previous scan in 2021 showed a lowest T-score of approximately -1.3, so the drop to -2.8 has been a shock. I went through menopause without HRT, had a demanding job, did very little exercise, and paid little attention to bone health. Although my doctor knew I was menopausal and had osteopenia, I wasn't aware how much bone loss could occur during this period. I have seen my doctor and am being referred to a specialist. MHT/HRT and osteoporosis medications have both been suggested. I am now about five years post-menopause. I don't have menopausal symptoms such as hot flushes, and my main concern is bone health.

My dilemma is deciding whether to:
Start MHT/HRT now and see whether it helps protect bone.
Go directly to osteoporosis medication.
Spend 12 months focusing on exercise, nutrition, calcium, vitamin D, and strength training, then repeat the DXA before making a treatment decision.

I am also concerned about the long-term commitment involved. MHT may be reasonable for five years, but I'm uncertain about the balance of benefits and risks beyond that, and I've read about the potential for bone loss after stopping treatment.

My questions are:
Has anyone started MHT/HRT around five years after menopause primarily for osteoporosis?
Was it worthwhile for your bone density?
Did anyone choose to monitor and focus on lifestyle changes for a year before starting medication?
If you had a T-score similar to mine (-2.8 at the femoral neck), what treatment path did you choose and why?
Looking back, would you make the same decision again?

Thank you. I'm still coming to terms with the diagnosis and would really appreciate hearing about other people's experiences.