You can begin hormone replacement therapy (HRT) as soon as you start experiencing menopausal symptoms.

The average age for women to experience the menopause in the UK is 51. However, some women have the menopause when they are in their 30s, 40s or 60s. There is no way of predicting exactly when the menopause will happen.

Some women have menopausal symptoms, such as hot flushes and vaginal dryness, in the three to four years before the menopause. This is known as the peri-menopause.

The peri-menopause occurs because levels of the female sex hormones, oestrogen and progesterone, fall when the number of remaining eggs drops below a certain level. This means you may experience menopausal symptoms even when you are still having periods.

In most cases, HRT can be used without taking a test to confirm you are starting the menopause. A test for the menopause is usually only necessary if you are under 40 years old or have unusual bleeding patterns during your period.

Testing can help rule out other conditions that may cause similar symptoms, such as having an overactive thyroid gland (hyperthyroidism). You should have regular smear tests for cervical cancer.

When HRT is not suitable

HRT may not be suitable if you:

• have a history of breast cancer, ovarian cancer or womb (uterus) cancer
• have a history of blood clots
• have a history of heart disease or stroke
• have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
• have liver disease
• are pregnant

In these circumstances, a different type of medication may be prescribed to help control your menopausal symptoms.

Read more about the alternatives to HRT.