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Menopause is the natural end of menstrual cycles, diagnosed after 12 months without a period. It usually occurs between ages 45–55. Perimenopause is the transition period when symptoms such as hot flashes and irregular cycles begin. Surgical menopause happens if both ovaries are removed.
HT is the most effective treatment for hot flashes, night sweats, and vaginal dryness. It helps protect bone health and may reduce the risk of type 2 diabetes. Starting HT before age 60 or within 10 years of menopause may provide heart health benefits.
Risks depend on age, health history, and type of HT. Oral estrogen slightly increases the risk of blood clots and stroke; transdermal estrogen (patch, gel, spray) carries lower risk. Combined estrogen-progestogen therapy may slightly increase breast cancer risk with long-term use. For most healthy women under 60, benefits outweigh risks and can improve cardiovascular disease, bone health, and symptoms.
If you have a uterus and take systemic estrogen, you need a progestogen to protect the uterine lining from cancer. Options include oral micronized progesterone or a progesterone-containing IUD. Women without a uterus usually do not need progesterone.
Yes. HT is not recommended for women with a history of breast cancer (specific types), unexplained vaginal bleeding, active liver disease, history of stroke, heart attack, or blood clots (depending on cause). These are considered contraindications, but every patient should be evaluated individually.
Low-dose vaginal estrogen treats dryness, painful sex, and recurrent UTIs. It is absorbed very little into the bloodstream and is considered safe, even for some women with a history of breast cancer, though decisions should be made with their oncologist.
There is no fixed limit. Use the lowest effective dose for the shortest duration needed, but treatment can be continued if benefits outweigh risks and symptoms persist. Regular check-ins with your provider are recommended.
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We listen first. Then we craft a plan that reflects your goals – bringing together hormone and non-hormone options, lifestyple guidance, and clear follow-up so you always feel supported.
