Would you take HRT mainly for osteopenia before menopause symptoms start?

[EngineerMumOf2]

Looking for some shared experiences or sensible advice from anyone who’s navigated this.
I’m in my mid-40s with two kids, fit, healthy BMI (around 50kg), active, non-smoker, non-drinker, eat well, and have never broken a bone. My periods are still regular (missed just one about a year ago), and thankfully I don’t have the classic perimenopause symptoms like hot flushes or brain fog. No family history of breast cancer or other cancers either. My mum had back and knee surgery in her 60s, but she's doing grand now.
A recent DXA scan showed slightly low bone density (osteopenia) in my lumbar spine. I asked about bioidentical/body-identical HRT to protect my bone mineral density, and a couple of months ago my GP agreed to prescribe cyclical HRT: Evorel 50 patches alongside Utrogestan 200mg (micronised progesterone, taken two weeks on, two weeks off).
Now that I’m taking it, I’m second-guessing myself. Given that I have virtually no vasomotor/perimeno symptoms and feel completely well, is it sensible to stay on HRT solely as a preventative measure for bone health at my age? Or would you hold off and rely on diet, weights, and lifestyle until actual perimenopausal symptoms kick in?
Would love to hear what your GPs or menopause specialists advised if you were found to have low spine density early on. What would you do?

This is interesting as I am about to ask my GP for the same thing. I hope I haven’t left it too late. T score for my spine on a recent DEXA scan of -1.5. Hips were fine.

I am 54, not underweight, don’t smoke, rarely drink, eat a good varied diet. I have been doing weights for the past few years. I had a 5 minute phone call with GP who just said ‘look at the NHS website for guidance on how to prevent osteoporosis’. I said I am already doing everything the NHS suggests!

I have now requested a full appointment to discuss menopause and HRT. I hadn’t requested it before but the DEXA scan has worried me a lot. I will talk to them about my other symptoms - poor sleep, tiredness, loss of libido etc but my main reason is the osteopenia but I am worried they will say that’s not a good enough reason.

My periods stopped at 49 - I have read that within 5 years is best to start HRT so hope it’s not too late.

@BeverleyBrooks That T score is not that low. but at 54 it could be dropping quite fast. You can lose up to 5% a year in the first few years post menopause.

You should ask for the Z score which means your bones are measured against age. (T score is based on a 30 year old.)

You have had an earlier menopause- average is 51-52.

HRT has most benefits when used 10 years after the last period, for heart benefits. You can use it any time after for other benefits.

You have more than enough symptoms to use HRT! sleep, libido etc.

@JinglingSpringbells thank you, I didn’t realise about the Z score, the GP didn’t explain that. It’s -0.5 which isn’t so bad.

However I would definitely like to prevent further bone density loss.