Q: Is it too late for me to try hormone therapy?

You say you’re seven years into menopause. You’re no longer having hot flashes or night sweats, but you’re aware of heart palpitations, occasional insomnia, anxiety, irritability, weight gain, and mental fogginess. You’re wondering if it’s too late for you to try hormone therapy and whether it could help with the symptoms that are of concern for you.

First of all, congratulations on upping your exercise regimen! That can make a difference in a number of aspects of health--as well as your feelings of strength and vitality. Exercise tops the list as lifestyle changes that are beneficial for menopausal symptoms, so I applaud your efforts and encourage you to continue.

The symptoms you share are absolutely on the list of many women who transition through menopause, or are, in other words, “hormonally related.” There isn’t, generally speaking, a “too late” in the timing to consider hormone therapy (HT). The exception is for women who are more than ten years beyond menopause and have known cardiovascular disease. For this group of women, initiating hormone therapy too long after menopause may introduce some increased cardiovascular risk.

The response to HT for palpitations, insomnia, mood disruptions (and by the way, anxiety and irritability are the top two I hear), weight gain, and mental fog is somewhat variable. We would expect some degree of benefit, but whether all of these symptoms respond favorably is hard to say.

Yours is the precise situation where I advise women (assuming no contraindications) to consider a course of HT to see how you feel. It usually takes two to three months to get a sense of benefit; there may be a dose adjustment in that time.

For many women it is well worth the trial to see how you respond and how much better (or not) you feel. Good luck!