What do you counsel her?
C) Discontinue HRT and start bisphosphonates or calcitonin.
Sorry
The patient is likely to need anti-resorptive therapy after HRT discontinuation. However, adequate assessment of the risk of fracture with BMD would confirm the need for treatment, allow to tailor therapy and to follow up the response to therapy. Most of the data for calcitonin has been shown to be beneficial in the spine only while the magnitude of BMD preservation, in the spine as well as in the hip, seems to be higher with bisphosphonates, particularly alendronate.