Patient description: The patient is a 25-year-old man with type 1 diabetes confirmed with molecular analysis 7 years ago. He presents to the clinic with shortness of breath and fatigue during activities. He claims mild dyspnea after climbing 3 floors, no dyspnea at rest and no angina (New York Heart Association class 2). He is diagnosed with cardiomyopathy that will be treated with ACE inhibitors and Beta blockers. His takes 70/30 Insulin and vitamin D supplements. His past medical history is not significant for any other medical issues. His family history is positive for DM type 1 in his uncle and his grandfather. His lab study is as bellow: FBS: 100 mg/dl HbA1c: 6.5% Cholesterol: 190 mg/dl TG: 140 mg/dl LDL: 125 mg/dl HDL: 40 mg/dl

Clinical trial eligibility criteria: eligible ages (years): 0.0-999.0,  Myocardial Ischemia Postmenopausal WISE and nonWISE study participants Normal/minimally diseased coronary arteries (<50% luminal diameter stenosis in all epicardial coronary arteries) within 36 months of ancillary study entry and no intercurrent MI, PTCA, CABG Any one (or multiple) of the following suggestive of myocardial ischemia within 36 months of ancillary study entry: 1. Abnormal P-31 magnetic resonance spectroscopy (a fall in quantitative PCr/ATP ratio >15% from control) performed at a WISE or nonWISE site 2. Positive exercise stress test (> or = 1mm horizontal or downsloping, or > or =1.5mm upsloping ST segment depression measured 0.08 msec after the J point), performed and/or interpretated by a WISE or WISE ancillary ancillary trial investigator 3. Reversible stress radionuclide perfusion defect > equivocal and not attributable to breast/imaging artifact. performed as part of the WISE protocol 4. Coronary artery flow reserve <2.25 performed. as part of using the WISE protocol No contraindications to 12 weeks of FemHRT or hormone replacement therapy Normal mammogram and pelvic exam (including PAP smear for those with an intact uterus) within 12 months of study entry Documented normal liver function testing (SGOT) within 3 months of study entry  Documented myocardial infarction, coronary artery bypass surgery or mechanical revascularization Systolic blood pressure >200 mmHg or diastolic blood pressure >105 mmHg LDL-cholesterol >190 mg/dl, triglycerides > or = 300 mg/dl Clinically significant hepatic or renal dysfunction (SGOT more than 1.2 times normal at baseline, serum creatinine >2) Uncontrolled diabetes mellitus (FBS > or = 225 mg/dl) or new onset diabetes until stabilized Clinically significant valvular heart disease, dilated cardiomyopathy, or congestive heart failure (NYHA Class IV or severe Class III) Currently on hormone replacement therapy and unwilling/unable to withdraw treatment prior to study, (participants are eligible for study entry 4-8 weeks following hormone replacement therapy withdrawal, at the discretion of the WISE ancillary trial Principal Investigator) Previous breast cancer, mammogram suggestive of cancer, or endometrial cancer without hysterectomy Abnormal uterine bleeding or abnormal Pap smear (SIL I, II or III, carcinoma in situ, or cancer) Previous deep venous thrombosis, pulmonary embolism, or other thromboembolic disorder