Had a complete hysterectomy in 2008 at the age of 58. I continue to use estrogen patch but my doctors seem to baulk frequently. I had extremely high blood pressure and I believe that the patch has helped. Had endometriosis and my blood pressure became a problem in my 40s and 50s and I think that premenopause fluctuations in estrogen contributed to the hypertension. I also developed migraines in my 40-50s related to the hypertension/and the estrogen fluctuations. My doctors point to a TIA as the reason they want me to forgo estrogen but I think it might have been a migraine episode. Anyhow my bp is good now and if that caused the TIA it is under control. I have one last tube of premarin cream. The doctor said I don't need it! I had terrible vulvar pain after my hysterectomy and only the premarin cream helped. Insurance companies don't want to pay for estrogen and especially the creams which are way too expensive.