I had severe osteoporosis (bone density was -3.2).  I also have COPD and use an inhaler occasionally.  I took Actonel for 3 years.  It didn't help my bone density, but it did hurt my joints.  I found a website where many women were voicing complaints similar to mine about joint pain, so I stopped taking it.  My joint pain went away.  I started HRT against my doctor's orders - I ordered my meds online since she wouldn't prescribe it.  I used Nuvelle for 3 years and my bone density has improved to -2.5.  (this is borderline osteopenia)  My doctor and my radiologist were both amazed.  My doctor said it was the Actonel working.  (sure, 3 years after I'd stopped taking it.)  My family history helped me to decide on HRT.  We have no history of breast cancer (supposedly HRT slightly increases the risk of breast cancer), but I do have a history of colon cancer on both sides of my family (HRT is supposed to slightly decrease the risk of colon cancer).  I figure it works in my favor.  My sister also has osteoporosis.  She's 3 years younger than I, and she's consistently refused to take any treatment except holistic.  This is not working for her - in the last 3 months she's broken both wrists.  I'm very worried, but she won't listen.  Recently I switched from Nuvelle to Kliogest because I was having heavy periods and 2 days of bad cramps every month.  Kliogest combines both meds in one pill and you don't get periods.  I don't know yet if it will work as well as the Nuvelle.  One other thing of interest.  I changed doctors last year and my new doc ran some blood tests.  Found out I was deficient in vitamin D - not a good thing for an osteoporsis patient!  I think I'm gluten intolerant - after many hours searching online.  Anyway, after I stopped eating wheat, my vitamin D levels returned to normal, so that is something else you might want to look into.  Hope this helps.