Hormone replacement therapy (HRT) for premature menopause

Written by: Professor Gordana Prelevic
Published: | Updated: 28/08/2023
Edited by: Lisa Heffernan

For most women, the menopause starts between the ages of 45 and 55, however sometimes the menopause can arrive sooner. The menopause is that point in a woman’s life when a woman’s oestrogen levels decline, periods stop, and a woman is no longer able to have a natural pregnancy.



Premature menopause (before the age of 40) and early menopause (before the age of 45), whether spontaneous or induced by surgery, chemotherapy or radiotherapy are associated with significant long-term health risks.


These health risks include:


The age of onset of a lack of oestrogen is the most important factor in determining long-term health. The younger the woman is at the time of being diagnosed with premature menopause, the greater the risk of all of the above-mentioned disorders.


We asked Professor Gordana Prelevic, leading consultant endocrinologist, to tell us how women can reduce health risks associated with premature menopause with the use of hormone replacement therapy.


More on osteoporosis


What can be done to reduce the health risks of premature menopause?


Oestrogen replacement can mitigate some long-term health risks. HRT or hormone replacement therapy is therefore strongly advised for women with premature menopause for long-term use up until the normal age of menopause, which is about 50 to 51 years. There is some evidence that restoring low oestrogen levels will reduce the later development of cardiovascular diseases such as osteoporosis and possibly dementia.


Your doctor can also advise you to make lifestyle changes to help protect your health, like taking calcium supplements to help keep your bones strong and dietary changes to keep your heart healthy.


The benefits of HRT for premature menopause


Many women find that after a few months of hormone replacement therapy, symptoms of the menopause like night sweats, hot flushes and mood swings improve, and energy levels increase. As well as improving symptoms, HRT reduces your risk of developing the health risks associated with premature menopause as mentioned before.

  • Risk of cardiovascular disease is reduced and HRT can help to lower cholesterol.
  • Bone loss can be prevented, reducing your risk of osteoporosis which is associated with reduced levels of oestrogen.
  • The risk of developing Alzheimer’s disease is lowered.


Are there risks with HRT?


Some women might fear that long-term use of HRT increases the risk of breast cancer. It is well-known that women with premature menopause have a decreased risk of breast cancer. Therefore, a well-balanced standard HRT dose is not expected to increase the risk of breast cancer, at least up to the age of 50. If the ovaries had continued to function, women would be exposed to much higher levels of oestrogen and progesterone than those present in standard HRT.


Along with risks, sometimes women might experience negative side effects with HRT, like skin irritation with gel patches or leg cramps which subside after a few weeks. The delivery method can be changed if side effects persist.


More on HRT risks


Professor Gordana Prelevic advises women with early onset of the menopause to consider HRT to avoid health risks like osteoporosis or heart disease. To find more information about the menopause or if you are in search of an endocrinologist that specialises in premature menopause, don't hesitate to visit Professor Prelevic’s Top Doctors profile today.

By Professor Gordana Prelevic
Endocrinology, diabetes & metabolism

Professor Gordana Prelevic is one of London's leading consultant endocrinologists with over 40 years of experience. Her main area of expertise is reproductive endocrinology with special interests in polycystic ovary syndrome (PCOS), menopause, and osteoporosis

Professor Prelevic earned a Doctor of Medicine (MD) in 1971, a Master of Science (MSc) in endocrinology in 1978, and a Doctor of Science (DSc) in reproductive endocrinology in 1985, all from the University of Belgrade. She was a professor of medicine at the Belgrade University School of Medicine and head of the division of endocrinology at Zvezdara University Medical Centre, Belgrade until 1993, when she moved to the UK. In 1995 she was awarded a Fellowship of the Royal College of Physicians.  

Professor Gordana Prelevic practises at the Golders Green Outpatients & Diagnostic Centre and the Platinum Medical Centre. In her clinic, she sees patients with a wide range of hormonal disorders and a large proportion of her work focuses on the management of perimenopausal and postmenopausal women. Additionally, she sees patients with unwanted hair growth (hirsutism), hyperprolactinaemia, infertility, and thyroid disorders. 

She has published extensively, particularly on various aspects of PCOS in peer-reviewed journals and has contributed to numerous book chapters. Her work has been presented at several scientific meetings internationally. From 1996 to 2005, she held a position as a senior lecturer in reproductive endocrinology at Royal Free & University College London Medical School. She also works as an expert witness in endocrinology and forms an integral part of various reputable professional bodies. 

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