Hormone Therapy for Every Stage of Midlife

Absolutely not.
Perimenopause — the years leading up to menopause — can start as early as your mid to late 30s.
During this time, hormone levels fluctuate unpredictably, often causing symptoms like anxiety, sleep problems, brain fog, mood swings, and cycle changes long before your period actually stops.

We prescribe hormone therapy based on your symptoms and stage of life, not your age alone.
When started during perimenopause, HRT can not only relieve symptoms but also support long-term health — protecting your heart, bones, and brain, and helping you live longer, healthier years ahead.

You’re not too young — you’re right on time to start understanding what your body is telling you.

 It’s a fair question — and one of the biggest sources of confusion about hormone therapy.

The short answer is no, modern HRT does not cause breast cancer or blood clots when prescribed appropriately.

The concern comes from an older 2002 study (the Women’s Health Initiative) that used oral, synthetic hormones in women who were much older than the typical HRT candidate.

While the data from that study were widely misrepresented, the actual findings — along with decades of follow-up research have shown:

• Estrogen alone (for women who’ve had a hysterectomy) does not increase breast cancer risk — and it canreduce it by 20%
   
• Estrogen plus micronized progesterone (bioidentical, plant-derived) carries no increased risk compared to baseline.
   
• Transdermal estrogen (patch, gel, vaginal ring or spray) does not increase clot risk, because it bypasses the liver.
   
• The higher risks are seen with oral synthetic hormones and pellet therapy — which we do not use.
   

For most healthy women under 60, or within 10 years of menopause, HRT is considered safe, effective, and protective — supporting heart, bone, and brain health while improving overall well-being.

We base our care on current, peer-reviewed evidence — not outdated fear.

Ask us for the studies — we’ll happily share them.

For most healthy women under 60 or within 10 years of menopause, research shows HRT is safe and beneficial.
It can help with more than symptoms— studies show it can protect bone, heart, and brain health, and may help women live longer when started at the right time. 

If you're over 60, that doesn't mean you can't be on HRT. It just means we need to have an in-depth discussion about you, your symptoms, and medical history to determine your risk vs benefit. 

 Many clinicians still rely on outdated information rooted in a misinterpretation of the early 2000s Women’s Health Initiative (WHI) study. In reality, the data from that study and decades of follow-up research show that the type, dose, delivery method and timing make all the difference — and today’s transdermal, bioidentical options are both safe and protective for most women.

 “Bioidentical” means the hormone has the same molecular structure as the ones your body naturally makes.
These don't have to be compounded, mystery blends — they’re standardized, FDA-approved medications backed by research and quality control. 

 No — and that’s intentional.

We do not order blood work before your first visit. Your appointment is where we learn your full medical history, understand your symptoms, and discuss your goals. That’s just good medical care.

For most women, labs are not required before starting hormone therapy.

Current guidelines from The Menopause Society support prescribing based on symptoms and history — not lab values alone — because hormone levels naturally fluctuate from day to day, especially in perimenopause.

Once we know your full story, we’ll decide together if labs are helpful. In some cases, we’ll check thyroid, cholesterol, or hormone levels to guide treatment or rule out other causes, but we never start with testing before understanding you.

Your care should start with a conversation, not a lab slip.

Pellet therapy delivers a fixed dose of hormones (often testosterone or estrogen) that can’t be adjusted once inserted.
We don’t use pellets because:

• The dose can’t be changed for months, even if side effects occur.
   
• Blood levels can spike too high, leading to acne, hair growth, mood swings, or bloating.
   
• There’s limited safety data compared to FDA-approved, adjustable options.
   

We use bioidentical hormones in forms approved by the FDA — patches, gels, vaginal rings, sprays, and capsules — so we can adjust your dose safely and precisely as your body responds.

That’s completely okay.
Hormone therapy isn’t the only option, and it’s not the right choice for everyone.

At The Menopause Clinic, we start by understanding your symptoms, health history, and goals — then we review all the options that make sense for you.

If HRT isn’t recommended or you prefer not to use it, we can create a non-hormonal plan that may include:

• Lifestyle and sleep strategies
   
• Evidence-based supplements
   
• Prescription non-hormonal medications for hot flashes or mood
   
• Support for sexual health, libido, and vaginal comfort
   

Our goal is the same either way — helping you feel better, think clearer, sleep deeper, and protect your long-term health.
You’ll never be pressured into treatment you don’t want. We’ll meet you exactly where you are.

That’s always an option — but it’s important to understand what that means for your body long-term.

Menopause is natural. So are diabetes and hypothyroidism — and we treat those because untreated hormone changes can lead to real health consequences.

When estrogen, progesterone, and testosterone decline, the body loses more than symptom stability. Over time, lower hormone levels are linked to:

• Higher risk of heart disease (the leading cause of death in women)
   
• Faster bone loss and higher fracture risk
   
• Increased insulin resistance and weight gain
   
• Decline in cognitive function and memory
   
• Discomfort with sexual health, sleep, and mood
   

Some women feel fine without hormone therapy. Others don’t — and there’s no prize for suffering through it.

Hormone therapy isn’t about reversing menopause or aging; it’s about protecting your heart, bones, and brain while helping you feel clear, energetic, and well in this stage of life.

If you choose not to use HRT, we’ll still support you with non-hormonal options and lifestyle care — because good medicine is about informed choice, not one-size-fits-all treatment.