Welcome to Your Menopause Primer

During your early teen years, your body began a remarkable cyclic journey shared by women throughout the ages. Now, that cycle is naturally winding down and nearing its conclusion: It’s menopause! It's probably the reason you're visiting this website.

The years before your final period — often called perimenopause or the “menopause transition” — can feel just as tumultuous as adolescence. Many women report feeling that this time is even more overwhelming. One 47-year-old we talked to put it this way: "There's so much more at stake during this ‘second puberty’ because now I’m the grownup and my mom's not here to bring me a heating pad and write me a note to get out of gym.” During perimenopause, changes may arise that feel unfamiliar and unsettling. Sudden anger, thinning hair, itchy ears, forgetfulness, joint pain, and the well-known hot flashes—puzzling and frustrating all at once.

What can you do with the overwhelm? Managing perimenopause symptoms is a highly individualized process. A strategy that works one year may not be as effective the next, but one proven option that has helped countless women is hormone therapy (HT). Some providers refer to it as hormone replacement therapy (HRT), but the terms are frequently used interchangeably. Hormone therapy supports the body with the estrogen and/or progestogen it requires. For decades, cells were consistently nurtured by these hormones. When levels begin to fluctuate or diminish, every organ system notices and may respond with a cascade of uncomfortable symptoms. HT helps restore hormonal equilibrium, often delivering significant relief.

In most cases, hormone therapy carries minimal risk and offers substantial benefits, reducing hot flashes and night sweats. Another less-noticeable advantage is the prevention of bone loss leading to osteoporosis. Choosing the right prescription involves close collaboration with a healthcare provider. This article may be your starting point for exploring available options.

Types of Hormone Therapy

Estrogen-only therapy is typically recommended for women who have had a hysterectomy. Those who do have a uterus usually benefit from estrogen-progestogen therapy (EPT), since estrogen alone can overstimulate the uterine lining and raise the risk of endometrial cancer. EPT comes in pills, patches, vaginal rings, tablets, and creams. Some formulations combine both hormones, while others allow individualized dosing of each. That might mean using two products: one in a pill, and one in a patch. One size definitely does not fit all, so if your current prescription is not offering relief, remember there are alternatives.

A brief note on testosterone: If intercourse has become painful or your drive has noticeably dropped off, it may be worthwhile to explore the option of adding a small amount of testosterone to the mix.

When to Start

It's important to identify who should not begin hormone therapy. Because of the potential increased risk of heart disease, starting HT is generally not recommended for women over 60 or those who have gone more than 10 years without a period. For all other women over 35 experiencing perimenopausal symptoms (or simply not feeling like themselves), talk to a knowledgeable healthcare provider. Relief is possible, and with the right medical team and a circle of support, you can restore your sense of balance and well-being.

For more in-depth reading, here’s the 2022 hormone therapy position statement of the North American Menopause Society.