The decision to take hormone replacement therapy during menopause is a very personal one. It all depends on your symptoms, and how they impact your everyday life. But that’s not all. In the last few years, we’ve learned a lot about menopausal hormone therapies and their risks, which has made doctors reevaluate who they offer it to. But that doesn't mean no one should take it.
If I see that a woman has disabling symptoms that are not helped by any non-hormonal measure or medication, I wouldn’t want her to suffer. If a woman has gone through menopause naturally at a normal age, and she has nothing in her health history that medically prohibits her from taking it, it is likely a reasonable choice if she wants it. We would choose the lowest dose for the shortest amount of time. And we would have her come in for a check-up every six months to a year to see if she still needs it and to make sure she hasn't developed any new health conditions that can increase her risk for problems.
But for women who enter menopause before their mid-40s, the considerations are much different. These are women who may have premature ovarian failure (POF) causing them to enter menopause before 40, or women in early menopause, which occurs before age 45. This also includes younger women who had their ovaries removed surgically or damaged from cancer therapy. These women often take hormone therapy because their bodies have been deprived of estrogen for a long time, and that can bring on a host of other health problems. So hormone therapy in these younger menopausal women may actually be beneficial to their health in the long run. It’s such a personal decision, and one that should be guided by an informed doctor.