Brief Answer: START OUT WITH MINIMUM DOSE. Detailed Answer: Hello Thanks for writing to us with your health concern. You must understand that HRT ( hormone replacement therapy ) is at best a temporary measure, not recommended to be taken beyond 3 years. When you started out with Premarin the first time round, what was the starting dose ? 1.27 is a high dosage, I would recommend starting at the lowest dose possible, and then escalating only if you need more. It is strongly recommended to talk to your doctor who has been with you during the length of your prescription, to guide you about the dosage. TO answer your question, it is best to start at the lowest possible dosage, and then titrating it as per your needs. All the best Please feel free to discuss further.

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Brief Answer: AS BELOW Detailed Answer: It is not advisable to continue HRT for so many years. Beyond 5 years, the risks outweigh the benefits. There are many non hormonal drugs to treat the symptoms such as hot flashes - antidepressants for example. I would not advice you to start the Premarin by yourself, unless you are totally desperate. It is best to discuss it with your doctor, as in my opinion, you should not continue HRT for so many years at a stretch . Discuss other drug options for your symptoms, schedule the appointment sooner if symptoms are intolerable. Take care.

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