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Why feeling fine doesn’t mean that everything IS fine!
Welcome to Ask Barbie, where I answer your burning questions about menopause.
Here, I answer the question: “Should I take HRT if I don’t have any symptoms of menopause?”
As you know, I always answer these questions by making sure you understand the logic behind the answer. Only then will you be able to use the information readily, without having to wonder about the question over and over again.
So, in order to answer this question, we need to go back to basics. And the two most basic steps to successful menopause management are:
By definition, menopause is when you lose your estradiol. Estradiol is the ovarian hormone that functioned as your fountain of youth. It kept you young on the inside and on the outside.
Well, when you lose your estradiol, you start aging rapidly on both the inside and the outside.
But these symptoms are not the only consequence of losing your estradiol. When you lose your estradiol, you start aging rapidly on the inside, also. And the inside aging involves rapid deterioration of your heart arteries, your bones, and your brain. And this results in a very high risk of:
So, in order to answer the question, “Should I take HRT if I don’t have any symptoms of menopause?” you have to consider your short-term goals versus your long-term goals.
Short-term goals involve merely alleviating your symptoms of menopause. Long-term goals involve preventing the three fatal diseases of menopause.
This is why designating your goals as the very first step to success.
If your only goal is to alleviate symptoms … and you have no symptoms, then you may not want to take HRT. But you need to be sure you are not ignoring the three fatal diseases of menopause. Nothing can prevent them as well as HRT can.
If your goal is to prevent the three fatal diseases of menopause, then whether or not you have symptoms is irrelevant. If your goal is to prevent long-term diseases, you would take HRT simply to prevent the long-term diseases … regardless of whether or not you have symptoms.
Unfortunately, most women pay much more attention to the symptoms than they do to the diseases. This is a huge mistake. The symptoms of menopause will not kill you; the diseases of menopause will.
I believe that you should be able to do whatever you want. All the decisions should be yours. But you should know what you’re doing. And if you don’t know that, regardless of whether or not you have symptoms, there are three fatal diseases that are consequences of losing your estrogen at the time of menopause … you could end up falling prey to the three diseases unknowingly.
The three fatal diseases of menopause are silent until deadly. This means that none of them produces any symptoms until it’s too late.
You feel fine and then BAM! You have a heart attack.
You feel fine and then BAM! You fracture your spine or hip, and end up disabled for the rest of your life.
You feel fine and then BAM! You get a diagnosis of Alzheimer’s disease.
So this is why I say define your goals first. Let your goals be your guide, rather than letting your symptoms be your guide. Things will turn out a lot better that way.
Some women think they are “lucky “if they have no symptoms of menopause. Unfortunately, they are mistaken. Symptoms get your attention. They function as a wake-up call. If you have symptoms of menopause, they will force you to learn more about menopause. And by learning more about menopause, you’ll discover that your symptoms are due to menopause … and that there are also three fatal diseases lurking.
If you have no symptoms of menopause and feel fine, you may think that everything is fine. But, actually, that is not the case. And the problem is that once you realize everything is not fine, it will be too late.
So women who have symptoms of menopause have what I would call a “noisy” menopause. The symptoms disrupt their lives and wake them up to the fact that something is wrong. They are suffering from a hormone deficiency.
Women who don’t have symptoms of menopause have what I would call a “silent” menopause. They don’t have any symptoms to wake them up. They think that, because they feel fine, everything is fine. But those unlucky women end up having the diseases later in life. And they have no idea that HRT could have prevented them.
So the short answer to this question IS a question for you!
If you ask me, I think having a noisy menopause with lots of symptoms is much better in the long term.
Given what you just learned, do you not agree?
Ask Barbie: Should I Take HRT if I Don’t Have Any Symptoms of Menopause?October 28, 2025 - 12:56 pmWhy a “silent” menopause free of “noisy” symptoms can actually be deadly.
Ask Barbie: What’s the Best Time to Start HRT for Menopause?October 8, 2025 - 6:19 pmTiming is everything: choose yours wisely!
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