For what it's worth, and opinions can vary among doctors, my endocrinologist told me that Evista is not a good SERM ot osteoporosis drug. He said that it's being marketed as a two-for but does neither job well. Just one opinion but I toss it in here as you're in research mode. I truly wish there were better choices for osteoporosis drugs as all of them have issues, though some are worse than others. I think that the future for osteoporosis care will rely on more data than the DEXA results and maybe genetic testing can identify a more precise path for prevention and treatment for an individual.