yes, its a shame. The reality is they don't know.

All they know based on WHI is if you take older women who weren't on HRT, then put them on a strong medicine (Prempro), you might find some issues for a small percent of them.

There are no long term studies for other kinds of hormones, and on younger women who had continuous supply.

The reason they say 5 years if that it's the next longest study that was done on estrogen only. It was done on younger women, using both a lower dose of Premarin only and a patch. (KEEPS) There were no heath issues of any kind found. So that's how we now have come up with the 5 years only rule.

My understanding is hot flashes are caused by fluctuations, not necessarily low estrogen. I don't take it though for hot flashes, I take it because my ortho pains become intense and I get very weak both physically and mentally and constant UTIs.