When is the best time to start hormone replacement therapy?

The menopausal symptoms begin during the perimenopause. There’s early-perimenopause when women’s cycle lengths change. That’s when we can measure these changes in memory performance. Women might not even know that they’re in the perimenopause and yet the cognitive abilities are shifting during that time. When women get into the late-perimenopause, that’s when they skip a period. They go 60 days without a period. During that phase is when we see the largest changes in memory performance. The good news for women is that memory performance bounces back, it appears, during post-menopause. If the memory changes are occurring during this perimenopausal transition, then the window of opportunity for women to start hormone replacement therapy is during perimenopause and not much later.