"Very often people go through life and slowly lose the ability to function. One day they cannot walk, constantly feel sad, have a poverty of thought, are easily confused, weak, fragile, and not able to have restorative sleep, and are incontinent... that's normal aging! There is a time in life for starting hormone replacement therapy, and starting it sooner is more effective than later."--Samuel M Becker, M.D.
Hormones decline with age. Hormone dysregulation is common. Dysregulation leads to hormones not being balanced. This happens in grumpy men and women. The perimenopausal stage and PMS symptoms are caused by hormones not being balanced.
Although it is possible to not have hot flashes with menopause, it doesn't mean there isn't hormone dysregulation. Weight gain increased with age is a dysregulation. Optimal bio-identical hormone replacement therapy involves evaluating symptoms, measuring blood levels, not ignoring symptoms, not passively waiting for disease, and replacing deficiencies. Anything else, is a sure way to develop age related functional decline.
Bio-identical hormone replacement therapy, nutraceuticals, exercise and correcting nutritional deficiencies is life enhancing. Estrogen, thyroid hormone, progesterone, dhea, cortisol, testosterone, insulin and other hormones do not cause cancer. Observational studies are different then causation studies. Remember, just because the rooster crows, it doesn't make the sun rise. Obese people tend to have higher estrogen and incidences of cancer. Estrogen doesn't make one obese! Estrogen does not cause cancer! Estrogen is an innocent bystander of this metabolic inflammatory state.
Progestin is not progesterone. Premarin is not only estradiol. Much of the information framing the publics perception about hormones is derived from conflicting conclusions, from different summaries, of poorly designed studies leading to massive disinformation.