I went through menopause nine years ago at age 45. Am I past the window for estrogen therapy?

You haven’t missed the “window” for starting estrogen, especially since you had an early menopause and you’re only 54 years old now—that’s young! It is generally considered safest to begin estrogen therapy within 10 years after menopause, but this is not a rigid rule.

Some women may decide years after menopause that they would like to begin estrogen (to curb hot flashes or night sweats, for example), and this calls for personalized decision-making that weighs the benefits versus the risks for the individual patient. Estrogen has been found to raise risk for blood clots, stroke and breast cancer (especially when taken with progestin). Some women who are not candidates for the pill form of estrogen may still be able to take a low-dose skin patch, gel or spray.