Perimenopause often begins in your late 30s or 40s, but the symptoms can be easy to overlook or misinterpret. You might notice irregular periods, disrupted sleep, mood swings, hot flashes, brain fog, or a dip in your libido. These signs can come and go, making it hard to connect the dots. Even if your period hasn’t stopped completely, fluctuating hormones may already be affecting how you feel.

That’s where bloodwork can help. Testing key hormone levels—like estrogen, progesterone, testosterone, thyroid function, and cortisol—can reveal patterns that explain what your body’s experiencing. While symptoms tell part of the story, your lab results help confirm what stage you're in and guide more accurate, personalized support.

This is one of the most common questions I hear—and it makes sense. HRT has been surrounded by confusion for years, largely due to outdated studies and myths that have circulated without context. The truth is, when prescribed thoughtfully and monitored closely, HRT is both safe and effective for many women.

One common myth is that HRT dramatically increases the risk of breast cancer. While this concern stemmed from early studies using older forms of hormone therapy, more recent research has shown that bioidentical hormones, when used under medical supervision, carry a much lower risk and offer significant benefits. Another myth is that HRT is only for women who are already in menopause—but starting during perimenopause can actually offer better symptom control and long-term protection for your bones, brain, and heart.

HRT isn’t a one-size-fits-all solution. The key is working with a practitioner who understands your unique needs, reviews your health history, and helps you decide what’s right for you. When used appropriately, HRT can restore balance, ease symptoms, and support your body as it moves through this natural transition.

Starting HRT during perimenopause offers more than symptom relief—it can play a key role in protecting long-term health. Research shows that timing matters. Women who begin hormone therapy within 10 years of menopause experience the greatest benefits and reduced risks. In fact, a meta-analysis of clinical trials found a 39% reduction in all-cause mortality for women who started HRT within that window. Another study published in Nature found that women who used estrogen therapy for even 1 to 3 years had a 40% lower risk of developing Alzheimer’s disease.

Beginning HRT during perimenopause allows your body to ease into hormonal shifts instead of experiencing a sharp decline. Many women report improved mood, mental clarity, energy, and more stable sleep when they start support early. It also helps reduce the frequency and severity of hot flashes, night sweats, and cycle-related symptoms that can feel overwhelming during this stage.

Beyond symptom relief, early HRT use can support bone density, maintain cardiovascular health, and help regulate insulin and metabolism. It’s about more than feeling better today—it’s about building a healthier future, too. Starting early gives your body the support it needs to stay resilient during a time of natural change.