How to Start Hormone Replacement Therapy and Next Steps

Hormonal change isn’t something you can predict or schedule. Even for women who anticipate menopause, the first stirrings of this new phase of life often come as a surprise, and  the first signs may be hard to recognize. It could start with a coarse hair that appears mysteriously on your upper lip or a period that’s a bit heavier than usual. But sooner or later, you realize these are the beginnings of the menopause transition.

For men, hormonal change may be even more difficult to identify. Unlike the drastic drop in hormones that occurs with menopause, most men experience a slow but steady decline of testosterone as they enter their 30s. While many retain healthy testosterone levels, those who don’t may not recognize the cause of their symptoms until they’ve become severe.

But there is no need to live with uncomfortable or distressing symptoms. Hormone replacement therapy can help you restore comfort and support midlife wellness. The first step is talking to your healthcare practitioner about how to start hormone replacement therapy.

When Should Hormone Replacement Therapy Start?

When to start hormone replacement therapy (HRT) and how long to continue treatment are questions that do not have simple answers. Each person’s hormone journey will be different. 

Before starting HRT, your healthcare practitioner will weigh the potential benefits against your personal risks. These factors will be considered:

Personal/Family Medical History:

Your personal and family medical histories will be taken into account when planning for HRT. These help your healthcare practitioner assess your risk of certain cancers and other health conditions, including heart disease, blood clots, and osteoporosis.


Your age is an important factor for determining when to start hormone therapy and how long it should continue. For women, there may be a critical window when HRT offers its greatest benefits.

Type of Therapy:

Certain types of HRT may not be appropriate for all patients. The type of hormone, dosage, and administration method should all be considered.

The standard recommendation for women is that HRT should be initiated before the age of 60 or within 10 years of menopause. HRT may also be beneficial during perimenopause, the years that precede menopause when hormone fluctuations may cause severe symptoms.

For men, there is no standard age recommendation for when to start HRT. Instead, therapy should be initiated when low testosterone is diagnosed. While this can happen at any time, the risk increases substantially with age.


How to Start Hormone Replacement Therapy

Though everyone will experience hormonal decline as they age, hormone replacement is not a one-size-fits-all undertaking. Each person’s hormones will change at a different rate, and everyone responds differently to the decline. In addition, a hormone level that triggers mild or no symptoms in one person may cause severe symptoms in another.

Though your primary care provider can certainly prescribe hormone therapy, a hormone health specialist has the expertise to address your unique hormonal landscape and may offer more treatment options and have. Practitioners who specialize in hormone replacement therapy will also be most up-to-date on treatment innovations.

How to start hormone replacement therapy:

  • Schedule a consultation. You may do this when symptoms start or even in anticipation of the next phase of life
  • Make a list of questions and be prepared to talk about the symptoms that are causing you concern
  • Complete diagnostic testing to assess your hormone levels and provide your doctor with the necessary information to create a treatment plan
  • Participate in personalized treatment plan development. Be sure to voice your preferences and concerns
  • Follow through with your treatment plan to achieve the best possible outcome

By partnering with a hormone health specialist and participating actively in your care, you can ensure that your treatment plan works well for you. You can also establish health and wellness goals for the next phase of your life.

Next Steps for Optimal Wellness

Knowing how to start hormone replacement therapy can be invaluable, but HRT is only one part of optimizing wellness [LINK TO: hormone optimization post when live]. These steps can help you set yourself up for success.

Monitor Symptoms

Once you’ve started HRT, it will take a few months to determine how well it’s working for you. It’s important to monitor your symptoms, note whether or not they are improving, and assess whether you are experiencing any new symptoms. This information will help your healthcare practitioner refine your plan. 

Make Lifestyle Adjustments

Your healthcare practitioner will likely recommend healthy lifestyle adjustments to support hormonal balance and overall health. These may include:

  • A balanced diet. This should include lean protein, complex carbohydrates, and a full range of vitamins and minerals.
  • A regular exercise routine. Exercise has great benefits. Aerobic exercise is essential for the cardiovascular system, helps you maintain a healthy weight, and safeguards your metabolic health. Weight-bearing exercise is good for your bones, while strength training [LINK TO: “7 Reasons Weight Training and Menopause Belong Together] supports physical, cognitive, and emotional health.
  • Nutraceuticals. Nutraceuticals may be used to augment your hormone therapy, nourish your mind and body, and support healthy aging.

If you smoke or drink excessively, your healthcare practitioner should provide you with resources to help you take control of these unhealthy behaviors.

Create Wellness Routines

The age at which HRT often coincides with the age at which the risk for chronic health problems increases substantially. These include osteoporosis, type 2 diabetes, cancer, and heart disease. Your healthcare practitioner can schedule screening for these health conditions.

Regular assessment of weight, blood pressure, blood glucose, and cholesterol are essential for monitoring cardiac and metabolic health. Periodic cancer screenings should include annual skin checks and a colonoscopy or suitable alternative at age 50. Vision checks and depression screenings are also important in midlife.
For women, additional testing will include a bone mineral density scan, mammograms, and Pap tests at specific intervals.For men, monitoring tests will include periodic manual prostate exams and blood tests for prostate-specific antigen (PSA).
Besides annual flu shots and tetanus/whooping cough shots every ten years, the shingles vaccine is recommended for adults over 50 and the pneumonia vaccine for those over 65.

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Getting physical exams and lab testing as recommended can greatly enhance overall wellness and help to maintain quality of life as you age.

What Does Hormone Replacement Mean for You?

Knowing how to start hormone replacement therapy can open up a path to lasting symptom relief and enduring good health. With an experienced hormone health specialist in your corner and an HRT plan designed especially for you, declining or imbalanced hormones don’t have to slow you down.

If you are wondering how to start hormone replacement therapy, the healthcare practitioners in the EVEXIAS Health Solutions network can help. Find a provider to learn more about our innovative and personalized treatment approach.