When to Start Hormone Replacement Therapy: Signs and Stages

1. During Perimenopause (Usually Ages 35–50)

Perimenopause is the transitional phase leading up to menopause, and symptoms can last anywhere from 2 to 10 years. This is often the ideal time to begin HRT because:

• Hormones are fluctuating but not yet fully depleted

• Early intervention can stabilize symptoms and prevent long-term decline

• Estrogen therapy started during perimenopause may be protective for brain and bone health

Common signs it’s time to consider HRT in perimenopause:

• Irregular periods

• Fatigue and irritability

• Increased anxiety or depression

• Hot flashes or night sweats

• Brain fog or forgetfulness

• Decreased libido

• Vaginal dryness or pain

When is the best time to start Hormone Replacement Therapy? 

When symptoms start disrupting your quality of life—often during the early to mid-40s.

2. At Menopause (Typically Age 45–55)

Menopause is defined as 12 consecutive months without a period. At this point, estrogen and progesterone levels have dropped significantly.

Starting HRT at this stage can:

• Restore hormonal balance

• Reduce the severity of hot flashes and sleep disturbances

• Protect against osteoporosis and cardiovascular decline

• Improve skin, hair, and mood

The “window of opportunity” to begin HRT is typically within 10 years of menopause onset for the best benefits and lowest risks.

3. Postmenopause (After Age 55)

While HRT is most commonly initiated in the years leading up to and just after menopause, some women benefit from beginning therapy later in life, especially if they have:

• Severe vaginal dryness or pain during intimacy

• Osteopenia or osteoporosis

• Persistent fatigue or mood disturbances

• Loss of muscle mass or frailty

Note: Starting HRT after age 60 may carry slightly higher cardiovascular risks, so careful screening is essential.

What the Research Says About Timing and Safety

Several studies have explored when to start hormone replacement therapy for the best outcomes. The “Timing Hypothesis” suggests that:

“HRT is safest and most effective when started early in the menopausal transition, ideally before age 60 or within 10 years of menopause.”

This window may offer the most cardiovascular and neurological protection while minimizing risks associated with estrogen therapy.

According to the Women’s Health Initiative:

• Estrogen therapy started in women under 60 was associated with a reduced risk of coronary heart disease.

• Bone density improved significantly in women who began HRT early in menopause.

• Cognitive decline and memory loss were less pronounced in early users.

How to Know If You’re Ready to Start HRT

Ask yourself:

• Are my symptoms affecting my daily life or relationships?

• Am I struggling with sleep, mood, or intimacy?

• Do I feel like a “different person” and can’t explain why?

• Am I concerned about long-term risks like osteoporosis or heart disease?

If you answered “yes” to any of the above, it may be time to schedule a consultation with your provider to explore hormone testing and personalized therapy.

Benefits of Starting BHRT at the Right Time

Starting BHRT with a personalized approach can offer incredible benefits, including:

• Improved Sleep Quality

• Stronger Bones and Muscles

• Heart and Brain Protection

• Better Mood and Mental Health

• Relief from Hot Flashes and Night Sweats

• Improved Skin, Hair, and Libido

Common Myths About When to Start HRT—Debunked

Myth 1: “You shouldn’t start HRT until menopause is over.”✅ Truth: Starting during perimenopause can help regulate symptoms and provide early protection.

Myth 2: “HRT is only for women in their 50s.”✅ Truth: Many women begin therapy in their 30s or 40s, especially those with early menopause.

Myth 3: “You can’t start HRT if you’re older than 60.”✅ Truth: While extra screening is needed, low-dose, localized therapies can be safe and beneficial later in life.

Why Choose Salud Healthcare for Hormone Replacement Therapy in Las Cruces

At Salud Healthcare, we provide bioidentical hormone therapy tailored to your unique needs—starting with comprehensive lab testing, symptom assessment, and ongoing monitoring.

Our BHRT Membership Includes:

• Personalized treatment plan

• Monthly care for just $80/month

• Ongoing dose adjustments as your body changes

• Access to your provider via text and telehealth

• Compassionate, women-focused care

Conclusion: Trust Your Body—and the Science

So, when is the right time to start hormone replacement therapy? The answer is personal, but clear: When your symptoms begin to interfere with your quality of life.

When you're ready to take control of your wellness journey.

When you want to feel like yourself again.

With early support and the right care, hormone therapy can help you feel more energetic, empowered, and in tune with your body.

Schedule Your BHRT Consultation Today

📍 Las Cruces, NM | 💬 Call/Text: (575) 218-7742 Let’s talk about how BHRT can help you thrive—no matter your age or stage.