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When is the best time to start menopausal hormone therapy (MHT)? |
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| A |
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Research shows that the best time to start MHT is within 10 years of the onset of menopause (12 months after your last period) or before age 60. Starting during this “window of opportunity” offers the most symptom relief and bone protection, while keeping risks like heart disease and stroke as low as possible.
You may see advice online suggesting that people start MHT as soon as perimenopause symptoms begin. However, starting MHT too early can have downsides:
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Longer hormone exposure: Starting early means you’ll be on hormones for more years, which may increase your risk for complications.
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Irregular bleeding: During perimenopause, your own hormone levels are still fluctuating. Adding MHT can cause unpredictable or heavy bleeding and may increase the risk of endometrial (uterine) problems if not properly balanced.
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Unnecessary risks: If your symptoms are mild or you’re not yet in menopause, you may be exposed to the risks of hormone therapy without much benefit.
However, if you go through menopause before age 40 (premature ovarian insufficiency) or before age 45 (early menopause), starting MHT sooner is usually recommended. This helps protect your bones, heart, and overall health until you reach the average age of natural menopause (around 50 to 51).
Your healthcare professional will look at several factors before recommending MHT:
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The severity of symptoms: MHT is most helpful for people with moderate to severe hot flashes, night sweats, sleep problems, or vaginal dryness that affect daily life.
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Your age and how long it’s been since menopause: Starting MHT later can increase the risk of heart disease, stroke, and dementia.
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Your personal and family health history: If you have a history of heart disease, blood clots, stroke, and breast cancer, MHT may not be recommended.
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Bone health: If you’re at risk for osteoporosis or fractures, MHT can help protect your bones, especially if started soon after menopause.
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Your preferences and lifestyle: Your healthcare professional will talk with you about your goals, concerns, and what matters most to you, so you can make a decision together.
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| Do you have any questions for our menopause experts? Let us know at menopause@healthline.com, and the answer may be featured in an upcoming edition! |
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| HEALTHY TIP |
| Use breathwork to manage hot flashes |
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The next time you feel a hot flash coming on, consider trying breathing exercises to help you cool down. Equal (box) breathing, cooling breath, and visualized breathing are just a few to try.
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