The clock is ticking for your hormones. Don't wait.

There is a special kind of luxury that no amount of money in the world can buy back once it’s gone: time. And when it comes to women’s hormonal health, Prof. Christian Breymann, MD, a gynecologist, researcher, and author of numerous scientific publications, has a clear message: Women who wait the longest often limit the potential benefits available to them.

In a world where we optimize our sleep, diet, skincare, and mental well-being, hormonal health remains surprisingly underdiscussed. Many women continue to navigate perimenopause and menopause with uncertainty. They often compare their experiences in private rather than turning to specialists with confidence. According to Prof. Breymann, this is precisely what constitutes both a cultural and a medical gap.

“The earlier you start, the greater the effect,” he explains. A growing body of research confirms what many specialists observe in clinical practice: Starting hormone replacement therapy closer to the onset of the first symptoms—or at the point when hormone levels begin to decline—can yield better results than intervening later. The often-discussed window of opportunity lies in the years following menopause. By then, the body’s tissues—including the cardiovascular, nervous, and skeletal systems—have already adapted to lower hormone levels. This can influence how the body responds to treatment. “If you wait too long, the changes have already occurred. Blood lipids have changed, bones have changed. The effect simply isn’t the same anymore.”

Why do so many women wait? Partly out of fear—a lingering echo of outdated studies that linked hormone replacement therapy to an increased risk of cancer, studies that were later heavily questioned and reevaluated. Partly because no one has told them they don’t have to wait. And partly because suffering in midlife has been tacitly normalized among women as a kind of rite of passage.

Prof. Breymann takes the discussion beyond the symptoms most commonly associated with menopause, such as hot flashes, night sweats, and sleep disturbances. For him, the deeper question is how hormonal balance affects the body on a systemic level. “Your body is only as healthy as your hormone levels. Every cell depends on metabolism. Hormones are like the power plant of every cell.” Estrogen is known to play a role in supporting bone density and various physiological functions, while research continues to explore its broader effects on long-term health.

Progesterone, which is often discussed less frequently, plays a complementary role. As Prof. Breymann explains, estrogen supports activity and energy during the day, while progesterone promotes rest and recovery. For women with a uterus, the combination of both hormones is an essential part of therapeutic considerations.

When it comes to how hormones are administered, he prefers transdermal application—typically as a spray or daily gel applied to the skin—over oral tablets. This method allows the hormones to be absorbed through the skin and can provide more stable levels. It also bypasses what is known as first-pass metabolism in the liver, which is one of the reasons why it is often preferred in certain cases. In Switzerland, a commonly used option is the Lenzetto spray, which was developed for easy everyday use.

He describes a patient who came to him despite a history of early-stage cancer—a situation in which hormone therapy might traditionally have been ruled out. In her case, the decision was made on an individual basis and with caution. A very low-dose treatment was considered because her menopausal symptoms were significantly impairing her quality of life. “Here, too, you have to look at the case individually,” he explains. “It’s not always a ‘no, never.’”

This emphasis on differentiation runs through everything Prof. Breymann advocates. There is no one-size-fits-all protocol, no universal starting point, and no solution that works for everyone. Each case requires a careful assessment in which risks, symptoms, and the individual context are weighed against one another.

At the same time, he highlights a common pattern: waiting too long can reduce the potential effectiveness of treatment. Women who seek advice early on, pay close attention to changes in their bodies, and consult specialists who take the full picture into account are often better able to make informed decisions.

Ultimately, time is the one luxury that cannot be replenished. The question is not whether it passes, but how it is used.

Prof. Christian Breymann, M.D., is a specialist in gynecology and obstetrics, the author of numerous scientific publications, and the founder and director of GYN & PERINATAL ZÜRICH, where he sees patients in Zurich.

Original English text: Maria May, Editor @kaizen­mags