@detc my hip is always worse on DEXA and there is a note on my report that the score for the hip is unreliable to measure change in bone density. You might want to ask about that.

How did you get the stress fracture? Are you sure it is related to osteoporosis?

You may not need medication yet. I suggest Keith McCormick's book The Whole Body Approach to Osteoporosis and maybe meeting with him. Dr. Lani Simpson has a website and Facebook group and may also be helpful.

The problem I see is that the "first line" meds approved by insurance, may affect the effectiveness of bone growing drugs like Forteo, Tymlos and Evenity. With a fracture, you might be eligible for those meds first, but your scores just aren't that bad,

I would avoid Prolia myself, because there is an abrupt drop off in density and high risk of fracture if you stop. Biphosphonates cause problems (dental and atypical fractures) if taken for many years so you would probably want to delay those too.

I think the key question here is whether your stress fracture was related to bone density and loss. The ideal sequence for treatment would be a bone-growing drug followed by intermittent biphosphonate with monitoring. But your scores, as I said, are not that bad.

Curious what your doctor says!