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The risk was driven by the synthetic progestin What Modern Research Shows The French E3N cohort study (80,000+ women) found no increased breast cancer risk with bioidentical estradiol plus micronized progesterone for up to 5 years The "timing hypothesis" shows women starting HRT within 10 years of menopause receive cardiovascular benefit rather than harm The Danish Osteoporosis Prevention Study showed reduced heart failure, MI, and mortality over 16 years of follow-up Major medical organizations NAMS, Endocrine Society, and IMS now endorse HRT for symptomatic women within the appropriate window Risks and Contraindications Hormone therapy is not risk-free, and we believe in complete transparency

doi: 10.1113/jphysiol.2002.032136

Taking injections in the evening rather than morning may help those affected by tiredness