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While a 2018 review found that taking progesterone and estrogen together can decrease this risk, [53] other reviews reported an increased risk of blood clots and pulmonary embolism when estrogen and progestogen were combined, particularly when treatment was started 10 years or more after menopause and when the women were older than 60 years ...
Its goal is to mitigate discomfort caused by diminished circulating estrogen after menopause. The 2002 Women's Health Initiative of the National Institutes of Health found disparate results for all cause mortality with hormone replacement, finding it to be lower when HRT was begun earlier, between age 50–59, but higher when begun after age 60.
There is mixed evidence about the effects of starting it over the age of 60, though some older women do experience relief from persistent symptoms. There is no limit for how long you can take it.
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The development of secondary sex characteristics in women is driven by estrogens, to be specific, estradiol. [11] [12] These changes are initiated at the time of puberty, most are enhanced during the reproductive years, and become less pronounced with declining estradiol support after menopause.
To be properly double blinded, the study required that women not be perimenopausal or have symptoms of menopause. As the average age of menopause is 51, this resulted in an older study population, with an average age of 63. Only 3.5% of the women were 50–54 years of age, the time when women usually decide whether to initiate hormonal therapy.
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