How long can I take hormone replacement therapy?

There's no formal time limit for hormone replacement therapy - this decision is individual based on your risk-benefit profile and reassessed yearly. Old thinking (pre-2010s) limiting hormone replacement therapy to 5 years is outdated. Current guidelines: (1) North American Menopause Society 2022 - hormone replacement therapy can continue as long as symptoms are disruptive, with annual reassessment. No strong evidence supports arbitrary stopping at year 5 or age 60. (2) Persatuan Obstetrik dan Ginekologi Malaysia - supports individualised approach, with decisions based on symptom severity, risk profile, and patient preference. (3) Royal College of Obstetricians and Gynaecologists UK - same. Factors affecting duration: (a) Symptom severity - women with persistent severe symptoms (hot flashes, vaginal dryness) often need longer hormone replacement therapy. (b) Risk profile - personal/family history of breast cancer, thrombosis, or heart disease affects decision. (c) hormone replacement therapy form - transdermal safer for long-term use than oral. (d) Additional benefits - hormone replacement therapy provides bone and heart-health protection if started early (within first 10 years of menopause, or before 60). Common approach: (i) Most Malaysian women take hormone replacement therapy 3-7 years for most severe symptoms. (ii) Some continue 10+ years if symptoms remain disruptive. (iii) When stopping, taper gradually (over 6-12 months) to reduce rebound symptoms. Annual reassessment with obstetrics and gynaecology specialist is the norm - includes breast exam, mammogram, blood pressure, and discussion of whether you still need hormone replacement therapy or can taper. It is a shared decision between you and your specialist, reviewed yearly.