I also struggled with this decision. I took Actinel for about two and a half years but I finally stopped because of side effects. I saw a number of different specialists--endocrinologists and rheumatologists. Most wanted to prescribe Forteo, a bone building drug which you self-inject daily for two years. I fought that for several years. I also knew that once I stopped the Forteo (it can only be taken for two years) I would begin to loose the bone that had been built. (That was a big concern for me.) The plan was to then switch to Prolia to maintain bone as best as I could. However, after fracturing several vertebrae (painful), I was warned that things were only going to get worse. I came to a decision that at this point in my life, the benefits would outweigh the possible side-effects. So, I did two years of forteo and yes, I did experience some side effects like low back pain and some knee discomfort. That went away when the treatment was over. I was then put on Prolia which I continue to take and have had no side effects that I'm aware of. Decision making on medication is a personal one. I found so many reasons not to do it. But in the end, I decided I didn't want to continue vertebral fractures, the pain and all the limitations that resulted. The Dr. who performed my kyphoplasty said that one of my vertebrae was like an eggshell. I don't believe my spine was going to support me long term. Weigh each side carefully. Read credible research and information only. Get second and third opinions, but in the end, the decision is yours.