Did you take Actonel or Atenelol? One is for angina and one is for osteoporosis. Do you have a heart condition and had to take Atenelol? I'm thinking you meant Actonel, but I need to be sure.
At 46, you're most likely perimenopausal - which is the 5 years or so leading into menopause. Your estrogen level drops and you can lose up to 20% of your bone density at this time. If your T-score is already into the osteoporosis range, you can be assured that it will drop even lower when you are completely menopausal. It is very important that you do something now to stop that slide.
The possible pregnancy factor is why the osteo meds aren't deemed suitable for premenopausal women. There just hasn't been enough testing on them in that respect to give a clearance. However, if there's no chance you could become pregnant, I'd suggest you take a med.
The biggest side effect in the oral bisphosphonates is the GERD. If that was your problem, you could try the Reclast annual infusion. There's also Evista, which is basically a synthetic hormone that has no effect on breast tissue.
The Prolia is meant to be used when all other meds have not been successful. I wouldn't see it as just another choice when you haven't tried the others.
Be sure that whatever you decide on, that you consume 1200 mg of calcium a day. The meds won't work if you don't give them the calcium to work with. Spread it out throughout the day as it's not easily absorbable. You also need 1000 IU of Vit D to send the calcium to the bones.
You can look through the National Osteoporosis Foundation website (
www.nof.org ) for a lot of good reliable information and an excellent FAQ section.