DEXA scores: mild vs. severe

prettyflower, fosamax was a decent choice at 55. That is when most of us start to lose the most estrogen and consequently the most bone. Even though your dxa shows -2.7, the fosamax probably saved you from greater bone loss.
I don't think of Prolia as a good choice. Partly because of the storied history of the drug, but mainly because it preserves older bone, essentially the same working mechanism as Fosamax, thought with different mechanism of action.
It isn't that -2.7 is severe osteoporosis. But consider that the bone you have is bisphosphonate-bone. Bone that has been preserved with all its little cracks and fissures that the the medication has prevented from self-repair.
You are living in a time when there are amazing drugs available for protection from fracture. And your primary has both made you aware and given you interum protection.
You could get a frax score, have another dexa, double up on your supplements, take alternate supplements, place an estrodial patch, and exercise.
At your level I'd "suggest" Forteo. I'd be happy if an overeager dxa (dxa over estimates bone loss in small bones) placed me in a position where I could get a prescription for this medication. I'd jump sooner than later because those vertebral fractures, unlike any other fracture, never heal into their original position.
Some people never fracture.
My order of choice would be Forteo, Tymlos, Evenity.
best wishes

Hi,
Windyshores, you may have answered this before. I've used forteo, alendronate and 3 months on evenity
My endocrinologist wants me to follow with prolia....... terrifying to me. I am 75. What would you follow with if it were you? Thanks

@gently This is wonderful information and insight. And it supports my instinct to hold back on Prolia. I am indeed on the cusp of small/medium boned. I'll get on the phone with insurance to see what their procedures are for Forteo acceptance or the other drugs you mentioned. May I ask what is the background on your knowledge? Thank you!

Looking into the anabolic (bone building) drugs such as Forteo, Tymlos, and Evenity is great advice from @gently. I'm so glad to know that you're doing that.

One example of the impressive potential gains with anabolic drugs comes from @windyshores who shared post-treatment results with Tymlos alone. https://connect.mayoclinic.org/discussion/dexa-results-after-mostly-partial-tymlos-dosing/

pretty flower,
you have to question everything. My background was observational until my bones started to dissolve. I've been on Forteo for nine months. I haven't had adverse events and have encouraging bone markers. Forteo was an easy choice for me; it saved my mother's bones. I likely made the choice twenty years ago. Some have adverse effects on Forteo and for some it is not effective.
I'm a lay person. I have seen an array of specialists, and chase all threads relating to osteoporosis through Pub Med, Scientific Frontiers, windyshores and even youtube. https://www.youtube.com/watch?v=Cd0YT-OV97c&t=44s
Besides being the best, Forteo is also the most expensive. I was on Alvogen the generic teriparatide in the US for three months. There are some co-paid cards offered through eli lilly. In case the insurance stymies you.
But, of course, first is the decision.
wishing you luck

Gravity 3, Prolia has a bad history because it wasn't known that you can't be late for or miss a dose. It wasn't known that you have to follow Prolia with another pharmaceutical. The destruction that followed was devastating. You might be safe with Prolia, now. Prolia is terrifying to me. Some report good results. If my endocrinologist wanted me to follow with Prolia, s/he'd never see me again.
In your situation, I'd take another round of Forteo.
I'd trust windyshores more than I'd trust gently.
I'm curious about why you are stopping Evenity after three month. That seems wise to me.

I am not stopping evenity. I am concerned about what comes next. Any advice is good. Thanks

gravity3,
since the first three months of Evenity are considered anabolic and the following nine partially antiresorptive, and anabolic after a full course has even more advantage.
Be careful, some advice is bad advice, though probably well intentioned

I can't bring myself to use prolia following evenity but my end is talking about it. Any thoughts?

Not end. Endocrinologist