There is a slightly increased risk of cardiovascular disease and a stroke for women over 60 who take HRT. This is more likely if they started HRT late into the menopause and use combined HRT. The risk can depend on the amount (dose) of HRT and how you take it.
For most women, if starting HRT before the age of 60, the benefits of HRT outweigh the risks. In women starting HRT when aged between 60 – 70 years, the benefits equal the risks. Starting HRT after the age of 60 does not lower the risk of heart disease but it is not thought that it increases it either.
The Multiple Benefits of HRT After 65
Introducing exogenous estrogen via HRT therefore not only addresses more overt postmenopause symptoms, it can offer protection against bone loss and help you prevent osteoporosis. These benefits are no less important once you reach the age of 65.
For women who start HRT more than 10 or 20 years after menopause starts or when they're age 60 or older, the risks of HRT are greater than the benefits because HRT is linked to a higher risk of heart disease, stroke, blood clots, and dementia.
HRT can slightly increase the risk of breast cancer. If you've had breast cancer you'll usually be advised not to take HRT. The increased risk is low: there are around 5 extra cases of breast cancer in every 1,000 women who take combined HRT for 5 years.
Endometrial (womb) cancer: oestrogen-only HRT increases the risk of womb cancer. This increased risk gets bigger the longer HRT is used, and may stay for some years after HRT is stopped. This is why it is usually only prescribed to people who are not at risk of womb cancer.
Over the last 15 years, these studies, and others, have found little or no evidence that HRT reduces the risk of heart disease. In fact, they have found evidence for an increased risk of blood clots and stroke. They also found an increased risk of breast and ovarian cancer in women using HRT.
HRT for older women
Even a small amount of estrogen replacement can often alleviate your symptoms effectively and provide you with the bone and heart protection you need. If you still have your womb (uterus) you will also need to take a progestogen, such as micronised progesterone, to protect the lining of your womb.
In addition to increasing longevity, hormone replacement therapy can help to address many of the changes we experience as we grow older. Estrogen therapy is associated with healthier and younger-looking skin in women.
Hormone therapy can be extremely beneficial for bone health purposes for women up to the age of 60 years, and in some circumstances women may continue hormone therapy after this age, depending on their general health, family history and bone density / history of fracture.
All women taking HRT should have an annual review with their doctor or nurse. If you continue to be healthy and feel the benefits of taking HRT, there is no reason for stopping it. Women are often surprised when their menopausal symptoms return after coming off HRT, even those women that have taken it for many years.
Approximately 9-16% of women over the age of 65 continue to have menopausal symptoms,1,2 and 13.7% of those women are using some form of menopausal hormone therapy (HT).
HRT is also known to help women maintain softer, smoother skin, resulting in a younger look. In addition to—and, often, as a result of—these physical changes, HRT often changes how you see yourself. In very real ways, using HRT to address symptoms of hormonal change can help you feel younger.
However, a Mayo Clinic study found that many women experience hot flashes, night sweats, insomnia, mood changes and other menopause symptoms beyond mid-life and into their 60s, 70s and even their 80s.
You can safely get relief with hormone therapy (HT), according to the North American Menopause Society (NAMS). Under some circumstances, low-dose HT, one of the most effective treatments for symptoms of menopause, may be appropriate for women over 65 who meet certain health criteria.
There's little evidence that most types of HRT make you put on weight.
The hormone estrogen is responsible for making skin look younger due to the hyaluronic acid it produces. Estrogen not only affects your skin but also your muscle mass, metabolism, and energy levels. Women have more estrogen than men do; men have more testosterone than women do.
Q: What are the benefits of starting HRT in the early stages of menopause? In women, if we can initiate therapy within five years of menopause or before age 60, you're getting the most benefits, according to scientific evidence.
Some women notice a difference within a few days, but for the majority it is a slow and steady improvement over weeks and months. You may notice physical symptoms get better first, for example, at the correct dose of estrogen, hot flushes and night sweats are often much better after 4-6 weeks.
One alternative that is now generating substantial interest is phytoestrogens and in particular a group called isoflavones. These are compounds found in foods that can behave in a similar way to oestrogen in the body.
There are many different HRT options available. Generally, the best option is one which provides a balance of good symptom relief with the lowest possible risk. For most women this is an oestrogen patch, gel or spray. This should be taken with some form of progesterone if you still have your womb.
Managing menopause symptoms without HRT
Cutting back on alcohol, caffeine, and spicy foods, and quitting smoking, can minimize your hot flashes. Exercising regularly can reduce your risk of weight gain, as well as symptoms of hot flashes and disrupted sleep.