The information leaflet for HRT is based on horse urine derived estrogen tablets and medroxyprogesterone given to old, sick, overweight women many years from menopause. Many of them smoked and had high blood pressure, diabetes and other risk factors.
Even then, with the absolute worst type of HRT they had NO increased mortality from any condition, and substantially reduced risk of osteoporotic fractures which are no joke and which NEVER gets mentioned, and a statistically significant reduction in colon cancer.
Instead of scaring yourself silly with outdated and medically inaccurate material, I don't want to make you feel worse but you really should weigh whatever concerns you have about hormones to the very real risks of untreated early menopause.
Whilst the official definition of early menopause is periods ceasing before 45, this is arbitrary, and at 46 with a FSH of 90 it is unlikely that you had healthy ovarian function one or two years ago, so if that were me at 46 I would manage it as early menopause.
Also if you are really keen to take the absolute lowest risk option, transdermal estrogen combined with micronised progesterone would be the treatment of choice, however any difference in real world risk with transdermal norethisterone is absolutely marginal and if you have other reasons for preferring the combi patch this is absolutely fine.
