Hi Mintea
Yes as I understand it the advice is to start HRT within 10 years of menopause ( ideally 5 years) and under 60 - for cardio-vascular health,. If starting over 60 then low dose transdermal HRT ( ie patch or gel) is recommended - and also for those with blood pressure issues. There is now no age or time limit for stopping and depends on a mutual decision betweemn you and your doctor and looking at all health issues.
Here are the BMS recommendations:
https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/"
HRT prescribed before the age of 60 or within 10 years of the menopause has a favourable benefit /risk profile and is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.
If HRT is used in women over 60 years of age, low doses should be started, preferably with a transdermal estradiol preparation."
However have you had other blood tests to determine whether your symptoms could be due to something else? Joint aches and tiredness can have multiple issues and I would be looking at thyroid function, and levels eg of vitamin D, iron etc.
However if you have severe VA that has not responded to increased doses of local oestrogen (how often do you use them?) then systemic HRT maybe diagnosed. If you look at Maryjane's posts (Jane Lewis) - she has written a book "Me and MY Menopausal Vagina" and is very knowledgeable about the whole issue - having done lots of publicity so also I suggest starting a new thread in the main menopause board "All Things Menopause" with vaginal issues etc in the subject title maybe?
Also there is an Estring which delivers higher doses of local oestrogen which is also a possibility if you haven't come across it?
The main problem with any HRT is the progestogen component which can provide challenging for some women! I am indeed 66 and taking HRT - but I started in late peri so the window of opportunity does not really apply as I hadn't got there yet!
Good luck and hope all goes well at your docs appt - do keep us informed..
Hurdity x