Some doctors are no longer prescribing medications for osteopenia, and the decision is more complex than just looking at a DEXA score. You have to look at risk versus benefit . Can you get a second opinion?

You may be able to use natural methods like diet , supplements (Vitamis D and K, others) and exercise (I recommend tai chi and walking). Maybe read "The Whole Body Approach to Osteoporosis" by McCormick.

I do not know your exact situation (have you fractured? Is your DEXA close to -2..5? ) or why the doctor is recommending Reclast. I would definitely consult an endocrinologist who specializes in osteoporosis before committing to Reclast.

Several articles online say this: "The first part of treatment involves diet and exercise choices. The risk of breaking a bone when you have osteopenia is fairly small, so doctors don’t usually prescribe medicine unless your BMD is close to the osteoporosis level."

The following article is 10 years old but the chart near the end may be helpful: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411311/

For context, I had actual osteoporosis (not osteopenia) for 14 years before fracturing last year. I was not resistant to meds but MD was leery of some and I reacted badly to others. My point is that I think you have a lot of time- possibly even years- before you have to decide on this, so take your time! You are in control.