1. Extended use of hormones is not necessarily bad. There is no upper age limit prescribed by research.
2. Dosages don't need to be adjusted as you age, they probably should be.
3. Bioidentical Hormone Therapy (BHT) may be safer and like your body's hormones, but this can be a myth as well. BHT means any menopausal hormone therapy that is identical to a hormone produced in the female body, but these aren't the only hormones we produce and not the only ones which are safe. For menopausal therapy it usually means 17Beta-Estradiol and actual hormone progesterone. Both estradiol and progesterone are approved for menopausal therapy. T
4. Menopausal hormones are just for hot flashes, is also a myth. The therapy is excellent for the treatment of hot flashes, for urinary health, for bone improvement; hormone therapy is not helpful to preventing decline of mental thinking or cognitive function and if you have had a uterine cancer you may need only progesterone therapy.
5. You may not need an individually designed dosage. You might however benefit from one, you must discuss with your gynecologist. Some women have applied this term to uniquely blended formulas designed for the individual woman. These blends may or may not contain only the estradiol, and many that are called biest or triest may contain the unapproved compound of estriol. In the recent position paper on hormone therapy by the North American Menopause Society they point out that the FDA has ruled that some compounding companies are making false claims regarding safety and that you are not to be given estriol without an investigation new drug authorization. If you are allergic to a component in traditional menopausal estrogen or progesterone therapy, then you may be a candidate for compounded therapy. Otherwise, they recommend approved government compounds for the treatment of your menopausal symptoms.
6. Women with premature menopause taking hormones do need hormones, and they are not necessarily at risk for the same complications, at the same rate, as older women started on hormone therapy.
7. Women with family history of breast cancer are often told they cannot use hormone therapy. This is probably not exclusively true.
8. Women should always understand personal risks of hormone therapy which could include deep vein clots, gall bladder or heart issues, stroke, cancer of uterus or breast, or heart attacks. The risks are low and can be managed by the correct dosages or timing.