@sut I have had four injections (the most recent on July 8). It has been exactly two years. I suspect the Prolia has made my irritable bowel with constipation worse and senokot has become my new best friend. In 2016 I went from being on no medications to being on three medications so who knows....I am pleased with the improvement I have made on Prolia. The most recent dexa scan was good. I'll be happy if I can get back to osteopenia! I would never consider oral bisphosphonates because I have acid reflux and dyspepsia at the best of times and upper g.i. problems are common with these drugs. So, I just keep evaluating Prolia every six months. The one negative is once on Prolia you cant discontinue cold turkey or you risk vertebral fractures. So a backup plan is needed.
There are pros and cons with all the osteoporosis drugs. For me, this was the best choice of what is presently available. I do not want to fracture my hip. The benefit of being on Prolia (for me) outweighs the risk. In my case diet and exercise alone was never ever going to solve my osteoporosis.
I also take 2000 I.u. of vitamin D a day and because my diet is definitely low in calcium, I have recently started taking calcium citrate (250mg × 2/day).