Thank you for consulting with Doctor spring. It is good to see you are well informed about the options for your health issues. Your age and symptoms suggest that you may be going in for menopause. Although the fact that your periods have been delayed, it does not mean that you will menstruate no more. Usually, your periods space out more, reduce in quantity to completely stop over a period of 6 months to a year. Regarding HRT, it is not routinely recommended currently for all women going into menopause. The U.S. Food and Drug Administration (FDA) now recommends that women with moderate to severe menopausal symptoms who want to try menopausal hormone therapy for relief use it for the shortest time needed and at the lowest effective dose. Like most women, your hot flashes or night sweats will likely go away over time. Considering the fact that your hot flushes are bearable, I don’t think you will need HRT. I recommend that you get your cholesterol levels rechecked because the beneficial effect of estrogen and progesterone is lost after menopause leading to worsening of your cholesterol levels. It would be good to add in some weight bearing exercises to maintain your bone density in addition to your routine exercise schedule.
Hormonal levels for testing the onset of menopause are not required. Its onset is diagnosed with symptoms and age alone. Yes there is an established increased risk of heart disease and osteoporosis. But they can be put off with wise eating choices, regular exercise and work ups. As far as breast cancer is concerned, although the risk does increase with menopause, your GP should be able to chart out a schedule for mammography depending on your other risk factors. Regular breast self examinations and pap smears are not to be forgotten.