how young is too young for hormone therapy?

Contrary to popular belief, you probably can (and should) be taking it sooner than you think.

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By now, you've probably heard the negative messaging around hormone therapy (also known as hormone replacement therapy or HRT). It's dangerous! It causes breast cancer! It'll make you gain weight! Except these are half-truths. Hormone therapy can actually be life-changing for menopausal women—and provide the most benefits, with the lowest risks, for perimenopausal women.

When we talk about hormone therapy, we're typically referring to low doses of estradiol (the primary form of estrogen in your body during your reproductive years) and progesterone. Unlike the hormones commonly found in birth control, these aren't synthetic hormones—they are known as bioidentical hormones, which have the same chemical makeup as the hormones in our body. Hormone therapy is FDA-approved to alleviate symptoms like hot flashes, night sweats, vaginal dryness, painful sex, and recurrent UTIs. It also offers some pretty amazing benefits, such as preserving bone health, improving heart health, and lowering the risk of diabetes. If a woman doesn't have a uterus, then she typically only takes estrogen, but if she does, she takes both estrogen and progesterone to protect the lining of the uterus from excess thickening.

In perimenopause, estrogen and progesterone fluctuate wildly, which can make it a little tricky to find the right dosage (usually you start on the lowest dose and go up based on response, tolerability, and efficacy). This is why ob-gyns will often recommend birth control pills or a progestin IUD—potentially with an added low dose of estradiol—as a first course of action to alleviate symptoms. The birth control can turn off the crazy fluctuating hormones (therefore controlling irregular periods and, in some cases, eliminating them completely). It also provides contraception since you can still get pregnant while in perimenopause.