01/22/2026
Dr. Jessi on Hormone Replacement Therapy — Part 5
This is where timing becomes everything.
When estrogen is started too late, after many years without hormonal support, the risk profile changes. Women naturally experience heart disease later than men in part because estrogen is protective. But if hormone therapy is initiated around age 63—after more than a decade post-menopause—there may already be plaque buildup in the arteries, which can increase cardiovascular risk.
This insight from the WHI helped shape what we now understand:
👉 Hormone therapy works best when started earlier, closer to menopause or during perimenopause.
The goal isn’t fear—it’s personalized, informed care based on physiology and timing, not outdated one-size-fits-all conclusions.
If you’ve been confused by mixed messages about HRT, you’re not alone—and the science has evolved.
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