I'm in the process of trying to obtain this for my dad and just spoke to a nurse yesterday regarding options.
He is 84 and frail, multiple vertebral fractures after being put on alendronate about 8 years ago and never followed up.
He wasn't able to comply with the very demanding instructions about taking the alendronate tablet early morning, ages before any other food or meds, so did his best and just took it with everything else.
He had no side effects, but wasn't taking it optimally, and his spine crumbled whilst on it.
I don't love the mechanism of action of bisphosphonates, however I accept that this is probably all that can be done for him at this stage - he isn't able to self administer the daily injections of anabolic therapy, and there's another monthly injectable anabolic option that I have asked for him to be considered for, but meantime we are taking the reclast, as any treatment is better than no treatment where osteoporosis is concerned.
That said, I wouldn't accept bisphosphonate treatment for myself and hope that physiological estrogen and androgen replacement plus being really diligent with lifestyle (both my parents have osteoporosis) will be enough for me.
If not, I would almost certainly choose one of the anabolic options which actually build new bone.
How old are you and what other therapies have you used/considered?