Is it safe to start menopausal hormone therapy after age 60 or more than 10 years post-menopause?

Starting menopausal hormone therapy (MHT) after age 60 or more than 10 years post-menopause is possible and can be safe, but it requires a more individualized approach and careful consideration of your personal health history and risk factors.

Here at Alloy, our menopause-trained doctors follow the latest guidelines from The Menopause Society, which state:

• The optimal time to start MHT is before age 60 or within 10 years of your last menstrual period, as this window provides the greatest benefits for heart and bone health.
• If you are over 60 or more than 10 years post-menopause, you can still start MHT, especially if you have persistent symptoms (like hot flashes or night sweats) or are at risk for osteoporosis. The benefits for bone health remain, and symptom relief is still achievable.
• For women starting MHT later, we recommend a thorough evaluation of your cardiovascular health (such as checking blood pressure, cholesterol, and possibly a coronary artery calcium score). If you do not have significant cardiovascular disease or other major risk factors, MHT can be considered.
• Transdermal (through the skin) estrogen is generally preferred over oral forms for women starting after age 60, as it carries a lower risk of blood clots.
• The decision to start MHT should be made together with your healthcare provider, weighing your symptoms, health goals, and any potential risks.

There is no strict age cutoff, and you do not need to stop MHT at a certain age if you are doing well and have no new contraindications.

For a detailed discussion from Alloy’s experts, check out these helpful resources:

• Watch Dr. Corinne Menn explain starting HRT after age 60 in this YouTube chapter: Starting HRT After Age 60
• Hear Dr. Sharon Malone address hormone therapy after age 60 in this YouTube chapter: Hormone Therapy After Age 60
• Read more about our approach and the latest guidelines on our blog: New Menopause Treatment Guidelines

If you’re interested in exploring your options, you can start with our Alloy Assessment to receive a personalized treatment plan from a menopause-trained doctor.

You can also browse our range of hormone therapy products to see what options might be right for you.

At Alloy, we’re here to support you with evidence-based, individualized care at every stage of menopause.

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This answer was created using the following resources:

• Your Menopause Questions Answered | Dr. Sharon Malone - Hormone Therapy After Age 60
• Hormone Therapy 101 with Alloy’s Very Own Dr. Corinne Menn! - Timing vs. Duration of Hormone Therapy
• All about Hormone Therapy | Dr. Corinne Menn - Starting HRT After Age 60
• Optimal Timing for Starting Hormone Therapy | Dr. Kudzai Dombo
• Estrogen Therapy: Biohacking for Women
• New Menopause Treatment Guidelines
• Catching Up With Dr. Corinne Menn | Alloy
• NAMS Issues Updated Guidelines on Hormones
• Alloy | Kudzai Dombo
• Catching Up with Dr. Sharon Malone | Alloy