I am 74 years old and started using a transdermal estradiol patch for osteopenia seven months ago. I also apply vaginal estrogen cream to prevent genitourinary syndrome of menopause (GSM), which leads to vaginal atrophy and is a progressive condition. Additionally, I use a compounded prescription of testosterone and DHEA for the vulvar area to help prevent urinary tract infections (UTIs) and atrophy of the urethra and clitoris. All of these hormones have been beneficial for me. Although the optimal time for prevention would have been during perimenopause, I am glad to be taking them now.