I am writing a general response that I think will answer many of the questions raised and also tell my story.
Firstly it is clear that it is still the case that people generally only discover that they have osteoporosis AFTER they break a bone. Personally I think everyone (male and female) should have a DEXA scan at say 60. One day the NHS will realises this is a cheaper option in the long run.
Secondly in the UK it is clear from the posts that the many GP’s are sadly lacking in knowledge of osteoporosis and instead of referring people to a rheumatologist they appear to dole out some pills which in many cases are inadequate.
I am male now 74. In 2019 I fractured three vertebrae. I was in a lot of pain and the last thought I had was that I had fractured my back. I thought it was muscular. I was in France and went to see an osteopath. This obviously did no good. When I was back in the uk I saw a physiotherapist. Obviously the wrong thing. I was still in pain and in fact spent 3 months sleeping on a recline chair as I could not get in and out of bed. I went to to see a back consultant and had an MRI SCAN. This confirmed that I had three fractured vertebrae. At this stage they had not compressed. (At this stage you can have cement injected into the vertebrae to stop them collapsing. By the time the NHS will get round to considering this they will have almost certainly compressed.)
I was referred to a rheumatologist (private). He immediately suggested Teriparatide. This is a self administered injection with a pen once a day for two years. The NHS would not prescribe this. I bit the bullet and paid. (£7,000 in all) This works to produce new bone tissue, thereby increasing bone mass and strength whereas the Bisphosponates slow bone loss. The NHS can now prescribe a new drug called Abaloparatide which is similar to teriparatide. There is an article about this in the Autumn edition of Osteoporosis News.
After that I have had three annual zoledronic acid infusions. This is a Bisphosponates. At the end of the teriparatide my bone density had improved. My back is generally not painful but aches if I stand doing something in the kitchen.
So my advice is pester the GP to refer you to a rheumatologist and they will know the best course of action.