Can you go on Tymlos, Forteo or Evenity? Tymlos and Forteo build bone. Evenity builds bone and is an antiresorptive like Prolia and the bisphosphonates. though less antiresorptive than the other two.

The problem with Prolia is what to do after you stop it. You cannot take a break or stop without risking a rapid drop in bone density. This is why my doc is not prescribing it. So what does your doc say you would go on after a few years on Prolia? Or does your doc want you on it forever? Long term use may pose the risks that concern you.

I have read studies that show that the bone building drugs are more effective if you don't take bisphosphonates or Prolia. If your scores are severe, your rate of bone loss is significant or you have fractures, insurance may cover the bone builders. Especially since you have tried alendronate. (I am on Tymlos)