You may start to notice subtle changes before you ever skip a period. You feel more tired than usual, your sleep becomes lighter or disrupted, and your mood seems harder to regulate. You may also experience hot flashes, night sweats, weight gain, vaginal dryness, and a declining libido. These symptoms often signal the hormonal shifts of perimenopause and menopause.
While these changes are natural, you do not have to simply endure them. At Genesis Lifestyle Medicine, hormone therapy is part of a personalized approach to restoring balance and helping you feel like yourself again.
Understanding when hormone therapy is typically started, and what factors influence that timing, can help you make an informed decision about your health.
What is the right age to start hormone therapy?
There is no single “correct” age that applies to every woman. Instead, hormone therapy is most often considered based on symptoms and overall health rather than a specific birthday.
For many women, symptoms of perimenopause begin in the early to mid-40s. This can last several years before menopause officially occurs, which is defined as going 12 consecutive months without a menstrual period. The average age of menopause is around 51.
Most women who start hormone therapy do so between the ages of 45 and 55. This range aligns with the period when estrogen and progesterone levels decline enough to cause most of the persistent and disruptive symptoms. Starting hormone therapy during this window is often referred to as the “optimal timing” because the benefits tend to outweigh the risks.
Some women experience early menopause (between ages 40 and 45) or premature menopause (before age 40). In these cases, hormone therapy may be recommended at a younger age to relieve symptoms and protect long-term bone, heart, and metabolic health.
There is no strict upper age limit for hormone therapy, but initiating systemic hormone therapy for the first time after age 60 is generally approached with greater caution.
Factors that determine when to start hormone therapy (besides age)
Severity and impact of symptoms
Occasional hot flashes or mild sleep changes may be manageable with lifestyle adjustments alone. However, frequent night sweats, chronic fatigue, mood swings, and vaginal discomfort that interfere with daily life often warrant medical treatment. If your symptoms are affecting your work performance, relationships, or sleep quality, hormone therapy may be appropriate regardless of your exact age.
Stage of hormonal transition
Women can consider hormone therapy during perimenopause or after menopause has occurred. During perimenopause, hormone levels fluctuate, which can create unpredictable symptoms. Hormone therapy can help stabilize these fluctuations and provide more consistent relief. Postmenopausal women may also benefit from hormone therapy if symptoms persist or worsen after periods have stopped. The key factor is not whether you are still menstruating, but whether hormonal imbalance is driving uncomfortable symptoms.
Overall health and medical history
Your personal and family medical history significantly influences when hormone therapy is recommended. Conditions like certain cancers, clotting disorders, liver disease, or uncontrolled cardiovascular disease may affect your eligibility. A thorough evaluation, including lab testing and screening, allows providers to determine whether hormone therapy is appropriate for you.
Type of symptoms you are experiencing
Different symptoms respond best to different types of therapy. For example, vaginal dryness, discomfort during intercourse, and urinary changes may be treated with localized estrogen therapy. Systemic symptoms such as hot flashes, night sweats, mood changes, and sleep disturbances often require systemic hormone therapy. The type of symptoms you have can influence not only whether you start therapy, but also which form and dosage are used.
Personal goals and quality-of-life priorities
Some women are primarily concerned with eliminating hot flashes and improving sleep. Others are focused on preserving bone density, supporting sexual health, or maintaining energy levels. Hormone therapy is not solely about symptom relief; it can also support long-term health and vitality. A personalized approach ensures treatment aligns with what matters most to you.
Are you a candidate for hormone therapy?
Whether hormone therapy is right for you depends less on your age and more on your symptoms, overall health, and how hormonal changes are affecting your quality of life. You may be a candidate for hormone therapy if you are experiencing moderate to severe perimenopausal or menopausal symptoms that interfere with your daily routine and well-being.
Symptoms that may warrant a consultation and evaluation include:
- Frequent hot flashes or night sweats
- Ongoing fatigue or low energy
- Trouble falling or staying asleep
- Mood swings, anxiety, or irritability
- Brain fog or difficulty concentrating
- Vaginal dryness or discomfort
- Low libido or changes in sexual function
- Unexplained weight gain or slowed metabolism
A comprehensive consultation is essential. At Genesis Lifestyle Medicine, this includes an in-depth discussion of your symptoms, medical history, lifestyle, and goals, along with appropriate lab testing. This allows providers to design a customized hormone therapy plan tailored to your body’s needs. Hormone therapy is not a one-size-fits-all solution. Dosage, delivery method, and ongoing monitoring are carefully adjusted to ensure optimal results while prioritizing safety.
Take control of your hormonal health
Menopause may be a natural stage of life, but struggling through it does not have to be. If you are noticing changes that affect your comfort or quality of life, hormone therapy may be worth exploring. Genesis Lifestyle Medicine offers personalized hormone therapy as part of a holistic, patient-centered approach to healing from the inside out. With expert guidance and ongoing support, you can restore balance, relieve symptoms, and move forward feeling healthier. Schedule your consultation with us today.
