Menopause is a Major Life Transition
Informed healthcare conversations matter.
Understanding Menopause and Symptom Changes
Menopause often brings new symptoms, changing health priorities and important treatment decisions.
For some women, hormone therapy may provide meaningful relief from symptoms such as hot flashes, sleep disruption and vaginal dryness.
Understanding both the benefits and potential risks, including considerations related to blood clots, can help support informed, individualized care.
Menopause is a natural stage of life that occurs when menstrual periods permanently stop, typically between the ages of 45 and 55. The years leading up to menopause, often called perimenopause, may involve fluctuating hormone levels and changing symptoms.
Women experience menopause differently. Some have mild symptoms, while others experience symptoms that significantly affect quality of life, sleep, work, relationships or emotional well-being.
Common symptoms may include:
For many women, menopause also marks a new phase in healthcare decision-making and in ongoing discussions about symptom management, preventive care, and overall health.
Hormone Therapy Is Not One-Size-Fits-All
Modern menopause care emphasizes individualized treatment rather than a single approach for all women.
For some women, hormone therapy may not be appropriate because of underlying medical conditions or personal risk factors. Others may benefit significantly from treatment when carefully selected and monitored.
Shared decision-making and periodic reassessment are now considered central components of menopause care.3
HEALTHCARE DECISIONS INVOLVING HORMONE THERAPY FOR MENOPAUSE SYMPTOMS MAY INCLUDE:
Symptoms & Lifestyle
Health History
Treatment Options
Blood Clot Risk & Hormone Therapy
One of the most important conversations surrounding menopause hormone therapy involves venous thromboembolism (VTE), which includes deep vein thrombosis (DVT, a blood clot in a person’s leg or arm) and pulmonary embolism (PE, a blood clot in a person’s lung).
Research consistently shows that oral estrogen therapy is associated with a higher risk for blood clots than transdermal forms of estrogen, such as patches, gels or sprays. Multiple professional organizations now recognize that transdermal estrogen may carry a lower thrombotic risk and may be preferred for some women with elevated clotting risk factors.4
Learn more about the risk factors for blood clots and the signs and symptoms of blood clots: About Clots
Risk for blood clots may vary depending on:
Transdermal Versus Oral Estrogen: Route of Administration Matters
However, treatment decisions remain individualized and should always involve a healthcare provider familiar with a woman’s full medical history.
Women with Higher-Risk Histories
For women with certain medical histories, menopause management may require additional discussion and caution.
A personal history of blood clots, stroke, hormone-sensitive cancers, significant liver disease, or certain cardiovascular conditions may affect whether systemic hormone therapy is appropriate. In some cases, nonhormonal or localized vaginal therapies may be considered instead.7
Women with inherited clotting disorders or strong family histories of clotting may also benefit from more individualized risk assessment and, when appropriate, discussion with specialists.
The Importance of Ongoing Reassessment
Menopause care is not static.
Symptoms, health status, and treatment goals may change over time. Current guidance emphasizes periodic reassessment of:
There is no universal age at which hormone therapy must automatically stop. For some women, carefully selected therapy beyond age 65 may still be appropriate after individualized evaluation and counseling.8
Supporting Informed Conversations
At the Rowan Foundation, we believe women deserve clear, balanced information about menopause and hormone therapy.
For too long, conversations around menopause have often been shaped by confusion, conflicting headlines or fear rather than individualized discussion and informed decision-making.
Menopause is not simply the end of reproductive years. It is another important stage of women’s health that deserves thoughtful, evidence-based care.
Women should feel empowered to ask:
Information supports awareness. Awareness supports better care.
Menopause care should reflect a woman’s symptoms, health history, priorities and quality of life. Understanding current guidance around hormone therapy and blood clot risk can help support more informed conversations and individualized treatment decisions.
