While there are no studies directly comparing the timing of HRT initiation following surgical menopause, the dosage and timing of HRT should be discussed with your surgeon prior to the operation.
However, experts recommend beginning estrogen immediately following surgery and continuing until the typical age at natural menopause (around 51 years old) in order to protect bone, brain, and cardiovascular health. However, many individuals continue to safely use estrogens after this time, and some guidelines recommend continuing through age 60.
Some doctors we surveyed reported that they prefer to begin HRT as soon as the patient leaves the hospital (provided medical safety for the individual patient). Studies suggest that HRT is underused in surgical menopause, and so it is important to have discussions with your doctor prior to surgery about how you will work together to optimize HRT in surgical menopause.
Visit www.iapmd.org/surgery for lots of evidence based information and resources for those considering, going through or recovering from surgery for PMDD/PME.