“Too young for HRT” is unfortunately a common response — and one that reflects outdated training rather than current evidence or clinical guidelines.

NICE (National Institute for Health and Care Excellence) guidelines explicitly support HRT for symptomatic perimenopause from age 40 onwards, provided there are no specific contraindications. Being 43 with perimenopause symptoms is not “too young.” Age alone is not a reason to withhold treatment that would address your symptoms.

What you can do:

First, ask your doctor directly: “What specific contraindication are you concerned about for me?” If they have a genuine medical concern — a personal or family history of certain cancers, blood clotting disorders, or other conditions — that is a medical conversation worth having. But if the reason given is simply age, that is not a clinical contraindication.

Second, if you cannot get a satisfactory answer, seek a second opinion from a gynaecologist with a specific interest in menopause medicine or women’s hormonal health. In India, gynaecologists working at private hospitals or women’s health clinics in larger cities are often more up to date with current guidance.

Third, bring documentation. The NICE NG23 menopause guideline is publicly available and clearly states that women under 45 with perimenopause symptoms should be assessed individually. Sharing this information in an appointment is not confrontational — it is advocating for appropriate care.

You are entitled to a proper, individualised assessment based on your symptoms and medical history — not a dismissal based on your age.