@julie2020 I am 65 and also small-boned and slim and 5'2 (I used to be 5'3!). I am also a celiac and was diagnosed in my early 20's. I had osteopenia in my 40's and osteoporosis in my 50's. I have a history of a lot of cancer in my family (sister/breast cancer, mother/breast cancer and non-Hodgkins lymphoma, brother/leukemia). I refused all medication for osteoporosis until the age of 63 when I could no longer ignore the fact that my numbers were continuing to drop although my numbers for hip and spine were in the -3's.
Two years ago my endocrinologist's recommendation was to go on Forteo followed by Prolia. I refused the Forteo because that black box warning about bone cancer frightened me . Also, I have an arrythmia and reading the Forteo info, it mentions palpitations or a racing heart upon injection.
I went with Prolia. I have had three injections. My last bone density showed significant improvement in both the hip and spine. I am due for my fourth injection within the next few weeks. I believe the Prolia has made my irritable bowel worse and has caused worsening constipation issues leading to chronic use of laxatives. Also, after my third injection, I experienced weird chest discomfort and rib cage pressure. I saw my cardiologist and did a stress test (ruled out anything cardiac). I believe it was a reaction to the injection as it started about three to four days after.
I saw my endocrinologist in February/March to discuss stopping Prolia. Now, with Prolia there's no stopping. Once you stop you risk spontaneous vertebral fractures unless you take what is referred to as a relay drug which in my case would be Reclast. I also have upper g.i. issues so oral bisphosphonates like actonel are contraindicated. Because I am small, my doctor said I could probably go for 18 months before having another injection.
I just dont like the fact that Reclast is in your system for 18 months. So, its come down to better to stay with the devil I know? Reclast has a list of unappealing side effects. I fleetingly thought about the doing nothing option but that is too much of a risk.
It would be interesting to hear what your doctor has to say about Prolia.
The problem is that a hip fracture is a scary thought. The other problem is that the drug companies have to come up with better medications.
I will be speaking to my endocrinologist soon to finalize the next step (prolia again or Reclast).
Good luck. You have to be prepared to take a leap of faith.

@curlylocks, @julie2020, @sue225, and others facing similar issues. Good evening ladies. I see that two of you may be facing a medication decision for osteoporosis. We, (post-menopausal females and males with special needs) in an attempt to have stronger bones for longer and happier lives, have a lot of things to consider. What is our starting point, how old are we, what fractures have we already had, how active are we, do we have access to an endocrinologist or an institutional/research facility with an interest in this phase of all women's lives?

There are lots of questions. I have an opportunity this week to find out some answers to questions that pop up frequently. Tymlos or Forteo is just one of those questions. My repetitive question is, and then what? I am just completing my first year of Tymlos. No side effects, no worries about getting it anymore after it was back-ordered during the early COVID days. When will I see improvement....how much? Since I have severe allergies to bisphosphonates......there aren't many options. Evenity.....is a new medication. How does it work and for whom will it be beneficial?

Do you or anyone else who is sharing these posts have general or even specific questions right now? For those of you who are getting DEXA scans this spring what are you seeing? Improvements? Better than expected? Lacking in something?

For those who have chosen exercise and modified natural diets, how is that working at this point? What kinds of encouragement do you see or want to see?

I just thought that since I was facing these issues this week, I would find out a bit about what other women are thinking, questioning and worrying about. I am not easily convinced, one way or the other. I am looking, like you, for evidence of improvement. Help me out here......let me know what you would ask.

May you all have happiness and the causes of happiness.
Chris