The age at which hormone replacement therapy (HRT) can be started depends on several factors, including the reasons for needing HRT, the types of hormones being replaced, and an individual's overall health status. When appropriately prescribed and monitored by a healthcare provider, HRT can provide substantial benefits for many people.
For transgender individuals seeking gender-affirming HRT, current medical guidelines recommend:
- Starting with hormone blockers in early puberty for adolescents. This temporarily suppresses pubertal development and provides time to explore gender identity.
- Beginning feminizing or masculinizing hormone therapy around age 16. Estrogen or testosterone therapy induces desired secondary sex characteristics. However, treatment plans are customized based on each patient's unique needs and situation.
Adolescents may be eligible to begin HRT earlier in some cases, after thorough mental health evaluation and consent from both the patient and parents/guardians. Ongoing supervision by a multi-disciplinary medical team is essential.
For menopausal women considering HRT to relieve symptoms like hot flashes, night sweats, and vaginal atrophy, the best time to start is:
- Within 5 years of menopause onset, ideally before age 60. Benefits are shown to outweigh risks when HRT is initiated early in menopause.
- Potential risks of blood clots, stroke, and breast cancer increase with time since menopause. Delaying HRT onset requires carefully weighing benefits and risks.
- Some newer low-dose vaginal estrogen preparations can be safely started even after age 60 to help with genitourinary syndrome of menopause.
Both transgender and menopausal patients considering HRT should understand:
- Ongoing clinical monitoring is necessary to ensure effectiveness and mitigate risks. Follow-up blood work and health screenings will be required.
- Not smoking and maintaining heart health through diet and exercise can help reduce elevated risks from HRT like blood clots.
- Treatment plans must be individualized and symptoms managed through the lowest effective hormone doses.
- Most insurance plans cover medically necessary HRT, but copays or coinsurance may apply. Out-of-pocket costs can vary widely.
At Renewed Balance Clinic, we specialize in evidence-based transgender and menopausal HRT, providing compassionate care tailored to each person's needs. Scan the QR code below or visit to request an appointment!
I hope this overview on when to consider starting HRT has been helpful! Let me know if you have any other questions.
