I had a difficult reaction to Forteo and my doc didn't want me on Prolia or Reclast (long story) so I didn't meds for quite a few years. All I can tell you is that you never know when you will fracture, and when I did, it was three vertebrae at once. Added to 3 traumatic fractures a long time ago, I now have 6. The pain of this is very motivating, believe me. I am finding Tymlos much easier than Forteo, and started at a low dose then moved up slowly. Evenity is another possibility but newer. Side effects from Tymlos, if they occur, tend to fade. I think a -3.2 could be the start of more fragility, but your MD would know.