The most effective treatment for perimenopausal and menopausal symptoms is to replace the hormones your body can no longer produce. Taking HRT is also beneficial for long-term health, as women on therapy have a lower future risk of heart disease, osteoporosis, diabetes, depression, and dementia.
HRT – What Is It? HRT (hormone replacement therapy) is treatment that includes estrogen, often progesterone, and in some cases also testosterone.
Estrogen – This can be taken in several forms: skin patches, gels, sprays, or oral tablets. The most commonly used type is 17-beta estradiol, which has the same molecular structure as the estrogen naturally produced in your body. It is derived from yam root.
Progesterone – Women with a uterus must take progesterone alongside estrogen—this is called combined HRT. Taking estrogen alone can cause thickening of the uterine lining and increase the risk of uterine cancer; progesterone prevents this by keeping the lining thin and lowering the risk.
Testosterone – For women who, after several months on estrogen, still experience fatigue, brain fog, and low libido, adding testosterone (alongside estrogen) can help relieve these symptoms. Testosterone is available as gels or creams and is widely and safely prescribed by menopause specialists.
What Are the Benefits of HRT? Relief of symptoms – Most women feel like their “old selves” again within 3–6 months of starting HRT. Reduced osteoporosis risk – Bones are protected against the risks of estrogen deficiency.
Reduced cardiovascular risk – The likelihood of developing heart problems, stroke, or vascular dementia decreases significantly.
Reduced risk of other diseases – Women on HRT also have a lower risk of type 2 diabetes, osteoarthritis, bowel cancer, and depression in the future.
What Are the Risks?
For most women who start HRT before age 60, the benefits outweigh the risks. There are two small risks associated with HRT: breast cancer and thrombosis. Combined HRT (estrogen and progesterone) may be linked with a slight increase in breast cancer risk, but some studies suggest this risk is reduced when using micronized progesterone. The overall breast cancer risk with any form of HRT is low; by comparison, the risk is higher in women who are overweight or drink moderate amounts of alcohol.
What Are the Side Effects?
Side effects of HRT are uncommon, but some women experience mild breast tenderness or bleeding. These usually occur in the first few months of treatment and tend to settle as the body adapts to the hormones.
When Is the Best Time to Start HRT?
The most effective time to begin HRT is during perimenopause—before official menopause (defined as 12 months after the last period). This means women do not have to wait until their periods have completely stopped. The first step should be an open discussion with a doctor. It is important not to let discomfort drag on until symptoms become unbearable.
Note: Starting HRT earlier brings greater health benefits—don’t wait until symptoms worsen.
Menopause means living with long-term hormone deficiency which, if untreated, increases the risk of osteoporosis and heart disease in the future.
The risks and benefits of HRT must of course be carefully weighed. Every woman should decide what is right for her, based on her individual needs and her doctor’s recommendations.
