@lynn59, I don't think anyone really knows that answer for sure as a it's a sequence that hasn't been extensively studied. But if you well into menopause, the sooner you go on HRT, the less risk there is (supposedly. that too is up for debate as all we have to rely on is the WHI study). I know that HRT is not something Dr McCormick generally recommended in the past but he seems to be recognizing the benefits as more info becomes available so I would be interested to hear what he has to say if you wouldn't mind sharing after your appointment.

If you want to go on HRT, I would highly recommend a consult with a specialist in hormones. I've been on them for 5 years at the lowest transdermal patch of .025 estradiol and 100 mg oral micronized progesterone (the safest kind). I just had a consult with Dr Felice Gersh who is a very seasoned practioner in the use of HRT and she would like to increase my dose (of estrogen, not progesterone - the 100 mg is a general standard). The low dose can maintain my bone but with an increased dose, I may have some bone building. I'll have another appt with her at the end of october at which point we'll go over blood work and determine dosing. She only tests levels via bloodwork as she says saliva tests do not give an accurate picture. Interestingly, she is not testing my estradiol levels, just my other hormones. She already knows my estrogen is low due to menopause and low dose therapy and is familiar with dosing related to bone health so there is no need to test. If anyone lives local to SoCal, I highly recommend a consult. If you are outside of CA, she does telehealth appts but the first visit must be in person (by law). She has people come in from all over the world to see her. The only downside is that she is expensive (but she is really worth it).