FOLLOW UP WITH EVISTA AFTER BONE BUILDING DRUGS

I used Forteo for 24 months after having 13 spinal compression fractures. I followed that with one injection of Prolia and then 5 years of Evista (Raloxifene ). Numbers maintained fairly well. Bone density done every year and report stated "no significant bone loss". However, after 5 years the insignificant loss added up and another bone building agent was recommended . The Evenity was not covered and $800 a month. My insurance would however, cover me to take Forteo again, as it had proven to work. I was pleased with that, as did not feel confident with trying Evenity as it is made by same company as Prolia and more side effects.
I will go back on Evista once I've completed this second round of Forteo (I am actually taking the generic brand this time). They can no longer read my spine due to the previous fractures, but my January scores 2025 were
Left Formal Neck: T-score -3.3. Z score -1.6
Left total Hip: T-score: -2.8 Z score: -1.5
I started this new round of Forteo 9 months ago and will be having a bone density test in January 2026. Will post results then. I'm still trying to decide if I will do one shot of Prolia to "cement the results" as they say, but not sure at this point. I lost two molars on Prolia and still have a wee hole in my upper gums. By the way, my finger nails are no longer soft and breaking. I hope that's a good sign!!

I am curious why you want to use Evista rather than HRT for example. I was prescribed Evista as an alternative to HRT at the age of 41 when I went into early menopause. It wasn't until I did my first DEXA scan 20 years later I realised I had osteoporosis - total T score -2.5. I was told to go on Prolia immediately but refused. I continued on the Evista and my T score dipped and waned between -2.4 to -2.5 in the 5 years since diagnosis, with the spine in most recent test worsening to -2.6. Then 6 months ago I was persuaded to switch to HRT given its superior bone building properties. It was an option I was initially repeatedly refused due to the 24 year gap since menopause. But there has been a radical change of thinking on this issue, especially for those of us with osteoporosis. Certainly all the evidence shows HRT will deliver vastly superior results to Evista. That said, I do believe Evista did significantly slow my descent into osteoporosis given that all my younger sisters have far worse osteoporosis than me - including a sister 9 years my junior who has a spine T score of -3.7. Three of them are now on HRT, with one of them taking Tibolone as an alternative to HRT under the care of an endocrinologist. Her T score has improved significanrly from -3.5 to -2.8 in past 3 years

I am seeing a gyn tomorrow and hopeful she will put me on HRT. I am almost 68, 22 years post menopause. Did you have any difficulty persuading your doctor to put you on HRT?

Yes. I had essentially given up trying after being told by three doctors it would be dangerous and inappropriate to go onto HRT at my age (66), 24 years after menopause. That just frightened me off. Then, bizarrely, I had to see a cardiologist this year and he is the one who suggested I try HRT. He referred me to a general practitioner who specialises in menopause. So you really have to go doctor shopping for HRT, despite the fact it is increasingly regarded as first line treatment for osteoporosis. Its madness.

Yes, it is.

Oh wow! That is such good information! I will look into that. No one has mentioned HRT as possible follow up therapy to me. The endocrinologist I have is pushing Evenity or Prolia and not interested in my views on the matter. And she was second opinion as my previous endocrinologist felt "out of her league" with my case and I have been unable to get in to anyone else now that this other doctor took over the case. What HRT are you taking? and dose? Just so I know what to ask for. Sounds very encouraging...

I was on HRT up until 5 years when we moved & my new primary care wouldn’t represcribe. Dexa scores have gone down since. Endocrinologist doesn’t believe in HRT. Where do I go next?? Very frustrating that so many doctors are not up to date on the benefits of HRT.

Your experience is unfortunately the norm. But depending on which country you are in you can find a list of doctors = generalists and specialists - who can help you. In the US its the North American Menopause Society. In Australia, the Australiasian Menopause Society. They both provide a "good' doctor list. I had hoped to find a sympathetic endocrinologist as I was so fearful of taking HRT at my age after such a long gap. But I wasnt in the right area and so far I have been reassured by my new HRT general practitioner that I am not so unusual. She put me on the lowest possible dose of estradiol gel; 0.1% @ 0.5g a day, 1 x 100mg cap of progesterone a day and a newly available vaginal pessary called Prasterone as she noted the vaginal pessaries I have been using for more than 20 years were doing nothing for me! It will be another 6 months before I will see what impact it has had on my bones but in the meantime it has already delivered some life changing results in terms of vastly improving my mood, anxiety, chronic and an over active bladder which forced me to get up during the night - often up to 10 times. Now its just once or twice a night. Its sensational. Certainly worth all the trouble you are going to find the right medico. And by the way, there are numerous studies which have found you can be on biosphonates AND HRT at the same time if your osteoporosis is still in the severe category.

76 when I started bhrt. I had 38 years without hormones. Consulted with a gynecologist and my pcp. Neither wS willing at the time to prescribe bhrt. And my endocrinologist does not prescribe hormone treatments at all. I finally went to a functional medicine provider and have been on estradiol/testosterone pellet, estradiol vaginal cream and progesterone for a year. I am happy with the results. Quality of life instead of quantity is my motto at 77.

Glad you were persistent and are doing well. My first effort at this with a functional medicine practitioner was very unsatisfactory, and once I learned that my credit card charges of $150/visit were recorded on my receipts as $25, I quit. Looking for the right person now and I am not interested in the compounded products for myself. Thanks for sharing your journey and good luck!