I had osteoporosis when I started Letrozole/Femara last August. As I had had an osteoporotic fracture I was able to access 6 monthly Prolia injections at the PBS price $38 rather than $275 .
I do not recommend bisphosphonate tablets which is the alternative to Prolia due to the risk of ONJ when dental extractions/ root canals etc are required. I took them some years ago and needed an extraction and found it nearly impossible to find a dentist to help me - only Prof Goss who is head of our dental school would do so after a blood test called crosslaps which established my bone was still turning over..Prolia exits the system after 6 months allowing a window for dental work - bisphosphonates stay in the system long after you cease taking them.
I was very worried about having the injections because of Dr Google but know so many on these injections who are fine plus am aware they further reduce risk of breast cancer recurrence.In NYC Prolia is prescribed for bc patients even if they do not have osteoporosis to reduce the risk of recurrence.
I will be having a bone density test this August to see how my hips and spine are as part of my annual check bc checkup. I walk daily and do light weights twice a week.I also take Caltrate Bone and Muscle Health 2 tablets daily as per recommendatiom from the Australian Osteoporosis organisation (?).I too try to ensure adequate calcium in my diet - yogurt , cottage cheese etc.
Be aware Femara/ Letrozole can cause your cholesterol to rise sharply - I am careful with hard cheese and take low dose aspirin and Krill Oil tablets.Be careful if you have this issue and are offered statins - I found they caused major memory issues after about 4 months which was frightening but reversed rapidly after I stopped taking them.
Hope some of the above may help and if there is anything else I might be able to answer please ask.Will be most interested to hear how you go over the next 5 years but not sure if it will be an option for me .