During postmenopause, the estrogen in a woman’s body decreases and makes women more susceptible to diseases such as osteoporosis, vasomotor symptoms (VMS), and endometrial hyperplasia. Two treatments that lower the risk of these diseases are SERMs and ERT which have differing effects, and therefore there have been emerging treatments that combine SERMs and ERT to find the optimal medication. In a previous study, a combination of BZA (SERM) and CE (ERT) was found to prevent osteoporosis and VMS but had no effects on the endometrium. Another SERM, ORM, has the same effects as BZA except in the endometrium. Due to the difference between BZA and ORM, ORM/CE might make up for the deficit in the BZA/CE trials. The experiment will study the success of combining ORM with CE by measuring its effect on VMS, endometrium thickness, and osteoporosis. The exclusion and inclusion criteria will be the same as the BZA/CE trial. 1000 participants will be split into four groups: a placebo group, a group receiving CE, a group receiving ORM, and a group receiving a combination of ORM and CE. Every 6 months a checkup that measures VMS frequency, endometrium thickness, and bone density will take place. The results of this study could influence recommended treatments for postmenopausal women in the future and improve their quality of life by lowering the risk of osteoporosis, VMS, and endometrial hyperplasia. Future research can contain other combinations of SERMs and HRT, or other dosages of ORM/CE.