@sl303
The new recommendation by the Menopause Association says that age is not a limit for the use of HRT. What is important is your health and what HRT you choose to use. The research seems to lean decidedly towards BHRT and topical/vaginal as being the safest form of HRT. Some research shows that HRT is as effective as many forms of osteoporosis drugs.

@sl303 What is bioidentical?

@sl303
I have used BHRT progestereone topically on my breasts for years. I had cystic breasts which the progesterone eliminated. Perimenopause is a time which often has very high estradiol levels with a much lowered amount of protecting progesterone probably due to the lack of ovulation and the subsequent loss of progesterone. Bottom line higher estradiol rates can be dangerous for women, especially with their breasts.
I personally use saliva tests to check my progesterone, estradiol and testosterone levels.
I seem to continue to make my own estradiol; so I only use progesterone, testosterone and estriol topically/vaginally. Without the saliva test I am sure that my doctors would have given me estradiol which I believe would have set me up for problems with my breasts.
My sister had a similar situation; she went a different route than I did without the saliva tests and progesterone/BHRT. She eventually had a breast cancer. She had surgery and is taking an estrogen blocker. She is doing as well as one can with her hormones totally blocked and all the problems which that is causing. I do not know if progesterone and BHrT could have changed this story for her. I am encouraging her to consider progesterone in another year when she may no longer take the estrogen blockers.

@sl303 Hello, I had partial lumpectomy for DCIS stage zero and no history or genetic issues for breast cancer. I have been on HRT for over 20+ years but got off it temporarily as doctors did not recommend as they have to go with "Standard of Care" practice. I now take estrogen and testosterone at lowest dose with pellets inserted every 3-4 months. My risks are minor compared to the benefit. I tried Osteoporosis meds years ago and they did not increase bone density. I am 73 years old and exercise 3-4 times a week which involves walking, stretching and some weights. I also take calcium, vit D & K and other vitamins to increase bone density. I also have osteoarthritis and spondylothesis and IBS-C. I use a powdered magnesium glycinate with probiotic and prebiotic fiber in a shake and that helps with the IBS-C. Everyone is individual so what works for me may not for someone else. I do a lot of research as I was a professional in the field of education so I conducted a lot of research studies. Keep seeking out answers and don't give up keep trying things until you find what works for you.