What should be considered if starting or restarting estrogen therapy after age 60?
If you are considering starting or restarting estrogen therapy after age 60, here at Alloy we want you to know that it is possible, but there are some important considerations:
- The "optimal window" for starting estrogen therapy is before age 60 or within 10 years of your last menstrual period, as this timing offers the greatest benefits for cardiovascular and cognitive health.
- If you are outside this window (over 60 or more than 10 years since menopause), you can still start hormone therapy, but your doctor will take a closer look at your personal and family medical history, especially your risk factors for heart disease.
- It is often recommended to assess your cardiovascular risk, which may include checking cholesterol, blood pressure, and possibly a coronary artery calcium score.
- For women over 60, a transdermal (through the skin) estrogen option is generally preferred over oral estrogen, as it carries a lower risk of blood clots.
- The starting dose is usually lower, since older women may need less estrogen for benefits like bone protection.
- The main reasons to start after 60 are persistent symptoms (like hot flashes or night sweats) and osteoporosis prevention.
- The decision should be individualized, with a thorough discussion of risks and benefits between you and your menopause-trained clinician.
For a detailed discussion, we highly recommend watching Dr. Corinne Menn’s explanation in the YouTube chapter “Starting HRT After Age 60,” where she covers these points and more. You can watch it here: Starting HRT After Age 60 - Dr. Corinne Menn on YouTube.
If you’re interested in exploring your options, you can learn more about Alloy’s personalized hormone therapy and take our quick assessment to get started: Alloy Assessment.
At Alloy, our goal is to provide evidence-based, individualized care so you can make the best decision for your health and quality of life.
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