Reviewed By Blake Gilliam, CRNP
Reading Time: 5 minutes
As a woman, you know that perimenopause and menopause are a normal part of aging. You know about hormone replacement therapy, but you are not sure when you should start going down that road. You may have asked yourself whether your symptoms are severe enough to consider treatment or if this is simply a phase you need to push through.
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Should I Use HRT?
Hormone therapy is worth considering if you have symptoms that are affecting your daily life, such as hot flashes, night sweats, mood swings, depression and anxiety or vaginal dryness. Even if you aren’t experiencing severe symptoms, starting HRT early has many benefits.
Hormone replacement therapy can:
- Help preserve bone density and reduce the risk of osteoporosis and fractures
- Support cardiovascular health when started at the appropriate time and dose
- Protect against accelerated bone loss that commonly occurs after menopause
- Support healthy cholesterol levels and metabolic function
- Help maintain muscle mass and overall physical strength
- Contribute to long-term cognitive and neurological health in some women
Who Should Consider HRT?
Hormone replacement therapy is not prescribed based on age alone, but on symptoms, hormone levels, timing, and overall health.
HRT is often recommended in the following situations:
- During perimenopause, when hormone levels fluctuate and changes in sleep, mood, temperature regulation, or menstrual cycles begin to appear.
- After menopause, when estrogen levels decline more consistently and symptoms or long-term health concerns become more noticeable.
- When lab testing confirms low or declining hormone levels that align with physical or emotional changes.
- When quality of life has shifted, even if symptoms seem subtle at first or developed gradually.
- When preventive health becomes a priority, particularly for bone, cardiovascular, or metabolic support.
HRT is always individualized. A thorough evaluation helps determine whether hormone therapy is appropriate, which type may be safest, and how it should be monitored over time.
Recent Changes in Hormone Therapy Safety Guidance
In November, the FDA removed the black box warning from hormone replacement therapy, marking a significant shift in how HRT safety is communicated and understood.
This change reflects decades of additional research showing that earlier safety concerns were overstated for many women, particularly when hormone therapy is prescribed appropriately and started at the right time.
The FDA’s decision acknowledges that hormone replacement therapy can be a safe and effective option for many women when:
- Treatment is initiated during perimenopause or early menopause
- Hormones are prescribed based on symptoms, lab results, and medical history
- Dosing and delivery methods are carefully selected
- Ongoing monitoring is part of care
This update does not mean hormone therapy is appropriate for everyone. Individual risk factors and health history still matter. However, the removal of the black box warning represents an important correction in how the risks of hormone replacement therapy are presented and understood.
How to Decide if HRT Is Right for You
If you are approaching the age where perimenopause usually begins, it is worth having a conversation with a menopause specialist. Hormonal changes often start before symptoms become disruptive, and early evaluation can provide clarity about what is happening and what options may be appropriate.
That conversation typically includes:
- A review of symptoms and health changes, including sleep, energy, mood, and menstrual patterns.
- Hormone testing, to assess current levels and identify early decline or fluctuation.
- A review of personal and family medical history, with attention to factors that affect hormone therapy safety.
- Discussion of timing and treatment options, including whether monitoring, lifestyle support, or hormone therapy makes sense.
The goal is not to start treatment automatically, but to make informed decisions based on your individual health needs.
Menopause Care at Madison Integrative Medicine
At Madison Integrative Medicine, we focus on menopause care that is guided by careful evaluation, hormone testing, and individualized treatment decisions. We help you understand whether hormone replacement therapy is appropriate and how it may support your health over time.
To schedule a consultation at our wellness center in Madison, AL, call (256) 325-0955 or visit us at 1230 Slaughter Rd Suite C, Madison, AL.
FAQs
Is it better to go through menopause without HRT?
Not necessarily. Hormone replacement therapy is not only used for symptom relief. Declining estrogen levels can affect bone, cardiovascular, and metabolic health over time. Whether HRT is appropriate depends on timing, overall health, and individual risk factors.
Do you age better on HRT?
Hormone replacement therapy does not stop aging, but it can influence how the body ages after menopause. Estrogen plays a role in bone strength, cardiovascular health, muscle mass, and metabolic function. For some women, appropriate use of HRT during the menopausal transition may help support healthier aging compared to untreated hormone decline.
Is there an HRT specialist near me?
Blake Gilliam, CRNP, at Madison Integrative Medicine offers hormone testing and hormone replacement therapy. To book an appointment, call (256) 325-0955.
