I think the results vary from Individual to individual as they do with any medication. The thing about Fosamax is that it has some history. The side effects aren't as severe as with some of the other medications. I get the impression that doctors start a lot of their patients out on Fosamax. I think it's a good idea to start on Fosamax. It will slow bone loss. It's harder to catch up once a bone loss has gotten worse

It is common to start osteoporosis patients on Fosamax.
Lots depends upon your age, bone density and fracture risk. Your endocrinologist will sort that.
Fosamax, a bisphosphonate, works by preventing bone from remodling. It increases bone density gradually by preserving bone.
With antiresorptive bisphosphonates, like Fosamax, "small changes in BMD (a few percent) have been associated with dramatic, but varying, declines in vertebral fracture rates (30 to 90%)."
https://asbmr.onlinelibrary.wiley.com/doi/pdf/10.1359/jbmr.2000.15.2.183#:~:text=In%20the%20case%20of%20antiresorptive,rates%20(30%20to%2090%25).
If your fracture risk is high, your endocrinologist will want you to take an anabolic drug that works by increasing the development of new bone. The effect is quicker and the bone is stronger.
Bisphosphonates similar to fosamax are available as monthly, six month, and yearly injections.
An often seen side effect of Fosamax is reflux. You'll want to be careful to remain upright, sitting preferrably for thirty minutes after taking the pill. The effect is seen, though not as often with the injectables, so there is some physiologic cause other than position.
If you carefully read the side effect list of any pharmaceutical you may find yourself reluctant to take it. So I only offer a link. https://www.mayoclinic.org/drugs-supplements/alendronate-oral-route/side-effects/drg-20061571 Best wishes, may you never fracture.

Before starting Bisphosphonate, research how the risk assessment is presented. The following is from an article I read, and is mentioned in articles by the NCBI. -- When discussing the risks and benefits of treatment with patients, healthcare professionals frequently communicate the potential benefits of treatment in terms of a relative risk reduction (RRR) in an event, and previous research has indicated that this increases the likelihood of people accepting treatment.

It has also been pointed out that presentation of data as RRR is often misleading. For example, in the context of osteoporosis, many bisphosphonates reduce the relative risk of hip fracture by 40% compared with placebo. Although this sounds impressive, the absolute benefit in terms of hip fractures prevented in osteopenic women with the characteristics of those treated by Reid and colleagues corresponds to a reduction from 12 fractures per 1000 women treated for 6 years to 8 fractures. This equates to an absolute reduction of 0.4%, 100 times less than the RRR.

Hi @alexxa. I moved your discussion and combined it with an existing discussion titled" Would like to know people's experience using Fosamax." - https://connect.mayoclinic.org/discussion/would-like-to-know-peoples-experience-using-fosomax/.

@alexxa, has your PCP discussed the risks and benefits with starting you on Fosamax now, even though your numbers aren't severe?