@karyn23 - it appears that the Royal OP Society https://theros.org.uk/information-and-support/treatments-and-medicines/a-to-z-list-of-medicines/hormone-replacement-therapy-hrt/ promotes HRT as effective as bisphosphonates. Seems that (thinking outside the conventional medical box) if one was taking Evenity and HRT and had significant improvement, then she could continue with HRT as the follow-up to maintain the gains...just a thought...