There is no set answer for this. Your doctor will likely have an established approach in the way they apply this treatment. Do discuss your concerns with them. Your doctor may want to first see how you tolerate the cycle suppression and the drop in your hormones before giving you HRT.
There is value in seeing how you do initially with complete ovarian suppression for a month or so and then seeing how you tolerate add back hormones (HRT). However, for some patients it may be easier to tolerate chemical menopause if HRT is started at the same time as GnRHa treatment.
It is not advisable to be on GnRHa treatment for longer than 6 months without estrogen HRT as the lack of estrogen can cause bone thinning and other serious health issues..
If you are using the GnRHa treatment as a ‘test’ before having ovary removal surgery for PMDD, it is highly advisable to see if you tolerate the appropriate HRT before you proceed with surgical menopause.
Estrogen-therapy in surgical menopause is a crucial part in safeguarding your long term health and provides many protective benefits.
What if I was not prescribed HRT by my Dr?
Your doctor may want to first see how you tolerate cycle suppression and a drop in your hormones before giving you HRT. However, it would be a good idea to see if you tolerate the appropriate HRT before you proceed with surgical menopause.
If your provider is not suggesting HRT after the first 6 months, we would recommend taking them official guidance regarding the importance of estrogen therapy in chemical menopause.