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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Too old or too late for hrt?  (Read 8673 times)

MichelleDT

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Too old or too late for hrt?
« on: October 20, 2019, 10:07:22 AM »

Was wondering if it's ever too late to start taking hrt? I had my last period 11 years ago and to be quite honest I feel like I've lost the last 11 years! I've felt unattractive, miserable, sleep is awful, never feel like doing anything, feel isolated as I don't like socialising as I get anxious etc. I don't want to waste any more of my life. I used to always be out and about and enjoyed life. Any advice would be appreciated, thank you xx
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dahliagirl

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Re: Too old or too late for hrt?
« Reply #1 on: October 20, 2019, 10:21:24 AM »

How old were you when you started menopause, and how old are you now?

Did you see the programme that Kirsty Wark presented - she went back onto a low dose HRT after DEXA scans, but I think she had only been without for about 5 years (and probably on private health care).
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Viwi

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Re: Too old or too late for hrt?
« Reply #2 on: October 20, 2019, 11:05:30 AM »

My mum had total hysterectomy with Ovaries removal 7 years ago, and was never on HRT, when she heard from me that it's good for bones, she wanted to start, but her Ginecologist said that she shouldn't as it was too late in game. She could start 7-6 years ago, not now. Risk for High blood presure, blood cloth, heart attack increasing as hormonal levels go down with years, and now kicking body with hormons are not good. And from what i readed - if woman still have ovaries/womb - there is higher risk of sudden bleeding and ovarian cancer as ovaries that stoped working tend to be stiff.
But meaby it would be good to go and talk with GP if you have any discomfort in life that can be changed. :)
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Whatsupwiththis

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Re: Too old or too late for hrt?
« Reply #3 on: October 20, 2019, 12:53:14 PM »

MichelleDT. I am 68 and was recently dx'ed with severe vaginal atrophy approx. 6 months ago.  I asked my Dr. about going on the patch.  She flatly refused!  Apparently after age 60 most Dr.'s will not approve HRT if you've never taken HRT however vaginal HRT like Vagifem was quickly approved.  Good luck and keep us posted.
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jaycee

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Re: Too old or too late for hrt?
« Reply #4 on: October 20, 2019, 02:14:06 PM »

I went back on HRT at 73 , my Dr said there are women older than me still on it,so depends on the Dr and probably the persons general health,
I am not on any medication ,or have high blood pressure etc
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Whatsupwiththis

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Re: Too old or too late for hrt?
« Reply #5 on: October 20, 2019, 04:57:08 PM »

Exactly Stellajane.  My Dr. said if I had been previously on HRT she "might think" about it.  Too many negatives as we age i.e. stroke, heart failure etc.  Getting Vagifem was not a problem as she mentioned one doesn't need HRT unless one suffers from hot flushes and night sweats but for VA, local HRT is much better. 
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Bobidy

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Re: Too old or too late for hrt?
« Reply #6 on: October 20, 2019, 05:14:33 PM »

Perhaps you could send your question to Dr Curry, giving her detail on your age, potential risk factors, symptoms etc so that her reply can give you a starting point for discussion with your doctor. My understanding is that as long as you are aware of risk the decision should be yours for quality of life. Some doctors are not supportive though.

I know I constantly bang on about Dr Newson, but she has a patient in her 90's on HRT!

Good luck, you deserve your life back x
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MichelleDT

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Re: Too old or too late for hrt?
« Reply #7 on: October 20, 2019, 07:33:15 PM »

Thanks for all your replies! I was 46 when I had my last period and am 57 now. It sounds like the risks increase with age but I am in good health. I feel I need to speak to a specialist really. I have vaginal atrophy too but I couldn't get on with vagifem as i think it was responsible for giving me period like pains. As I am single this atrophy is like a mental barrier that stops me even looking for a partner! Just want to feel fun, sexy and confident!
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Whatsupwiththis

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Re: Too old or too late for hrt?
« Reply #8 on: October 20, 2019, 07:56:38 PM »

Have you tried any vaginal creams?  I believe in the UK it is Ovestin?  I think your age to get HRT is ok but check with the very knowledgeable ladies on this site.  As for fun, sexy and confident, that requires a mental adjustment and I'm sure your friends/family find you fun, sexy and confident!  The only person who doesn't is YOU.  Talk to your GP and discuss your feelings.  He/she might not be aware of your emotional state. 
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sheila99

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Re: Too old or too late for hrt?
« Reply #9 on: October 20, 2019, 08:01:56 PM »

You could ask for a referral to a menopause clinic if you don't want to go privately. I started on HRT last year when I was 57 but I was in peri. Transdermal is safer than oral but I'm not sure any research has been done specifically for this type. I can't understand why it should make any difference if you've been on it before as long as you start on a low dose.
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Katejo

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Re: Too old or too late for hrt?
« Reply #10 on: October 20, 2019, 10:08:59 PM »

Thanks for all your replies! I was 46 when I had my last period and am 57 now. It sounds like the risks increase with age but I am in good health. I feel I need to speak to a specialist really. I have vaginal atrophy too but I couldn't get on with vagifem as i think it was responsible for giving me period like pains. As I am single this atrophy is like a mental barrier that stops me even looking for a partner! Just want to feel fun, sexy and confident!
  I started HRT this year at 56 to supplement the benefits of Vagifem  and also prevent osteoporosis.  It has definitely improved the VA a lot. I was using Vagifem almost daily but now I only need it a couple of times a week.
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Hurdity

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Re: Too old or too late for hrt?
« Reply #11 on: October 21, 2019, 11:17:24 AM »

Hi MichelleDT

 :welcomemm:

The general view is that if started within 10 years of menopause or under 60 then the benefits generally outweigh the risks ( on balance and if you are otherwise healthy and minimise other risk factors). The risks of stroke and cardiovascular problems increase with age anyway hence the post 60 "cut-off) where the risks relative to benefits  slightly increase. Nevertheless if you have never taken HRT it is advised by the British Menopause Society and top gynaecologists that if you start ( post-60) then transdermal is preferred.

Here is the info:

"HRT prescribed before the age of 60 or within 10 years of the menopause has a favourable benefit /risk profile and is likely to be associated with a reduction in coronary heart disease and cardiovascular mortality.

If HRT is used in women over 60 years of age, low doses should be started, preferably with a transdermal estradiol preparation.
"

https://thebms.org.uk/publications/consensus-statements/hormone-replacement-therapy/

You could ask for a referral to a menopause clinic if you don't want to go privately. I started on HRT last year when I was 57 but I was in peri. Transdermal is safer than oral but I'm not sure any research has been done specifically for this type. I can't understand why it should make any difference if you've been on it before as long as you start on a low dose.

sheila99 - not sure what you are asking re research? Are you asking whether studies comparing transdermal and oral HRT wrt stroke risk etc have been carried out? If so then they surely have - no medical claim like this would be made without evidence.

Another quote from the BMS statement:

"Transdermal estradiol is unlikely to increase the risk of venous thrombosis or stroke above that of non-users and is associated with lower risk compared with oral estradiol."

BMS members have access to full consensus statements with studies backing up their recommendations. Also they published a paper along with Women's Health Concern detailing a lot of this info here (full paper + refs):
https://journals.sagepub.com/doi/full/10.1177/2053369116680501

As you were a long time without HRT and had your last period several years before the average age of natural menopause then several years of HRT will benefit your bone health.
I think the key is though that you "went back on it" jaycee. Its starting, having not been on it before, that most GPs seem very wary of.

It's not whether you have been on it or not per se as I understand - it is the age of the woman combined with the time since menopause (or last HRT) because of this so-called "window of opportunity" for cardio-vascular protection and there have been studies about the effects I think of oral HRT and arterial damage, many years since oestrogen stopped (either naturally or artificially), where there can be an issue. I think it's to do with arterial plaque - build up on arterial walls - but I am a bit hazy on the details so just saying this from memory!!!

Your doc should be able to prescribe HRT at you age without reference to a specialist - subject to all the health checks etc - but if s/he doesn't feel comfprtable then definitley ask for a referral to a menopause clinic to put your/their mind at rest?

I went back on HRT at 73 , my Dr said there are women older than me still on it,so depends on the Dr and probably the persons general health,
I am not on any medication ,or have high blood pressure etc

Wow jaycee that's amazing! How long had you been off it and do you have uterus? Were you OK symptoms-wise oging back on it - sorry I can't remember your story!

Hurdity x
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hotmama

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Re: Too old or too late for hrt?
« Reply #12 on: October 21, 2019, 11:22:50 AM »

Hi MichelleDT, I started on a patch at age 64 and I'm now 69. I saw someone privately because I'd had unbearable symptoms for many years and felt I had no quality of life. I was told I should remain on it for the rest of my life and when I saw my GP she felt that it had improved my life so dramatically that she was willing to prescribe it on the NHS. I had a hysterectomy three years ago so only have to take oestrogen. I am aware of the risks but willing to take my chances as I am not overweight, I don't drink, I eat healthily and exercise five times a week. I will not be parted from my patch and recently travelled to Tenerife to buy them as I couldn't fulfil my repeat prescription in this country. Good luck with whatever you do and I hope that you get a few more replies from those on the site who have started late in life like myself.
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jaycee

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Re: Too old or too late for hrt?
« Reply #13 on: October 21, 2019, 12:01:47 PM »

I really can't remember how long since I was last on HRT but started at about 51 I think trying different ones, but the last before coming off it was Livial, and my Dr put me back on livial after having night sweats again, and for bone health,had thyroid tests etc all ok, I have stopped it again for now in case it has contributed to my hair loss, and although it did help me to sleep better it made me drowsy during the day
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Joaniepat

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Re: Too old or too late for hrt?
« Reply #14 on: October 21, 2019, 12:53:52 PM »

I went back on HRT (livial) aged 67. This was prescribed by my GP after I nagged him a bit. This was changed to oestrogen only treatment later that year by an NHS menopause clinic and after some trial and error I am now on Estradot 100 mcg patches. Age 70 now, and serum E level approximately 450 pmol/l. I also use Testogel, Vagifem and Estriol Cream.

I had a TAH/BSO at age 47 and took oestrogen until age 53/54, when it was stopped, against my will, by a previous GP who was spooked by the now discredited millennial studies. It was downhill all the way after that for the next 13 years.

My joints are now much better and there is slight improvement in osteopaenia. Mood, anxiety and sleep also much better. VA is an ongoing problem but is improving with local oestrogen plus MLT laser treatment. I have hypertension which is controlled with medication.

It took some cunning and a referral to the Chelsea & Westminster menopause clinic to get my HRT back. I want to stay on it forever and know of no reason not to.

JP x
« Last Edit: October 21, 2019, 12:57:18 PM by Joaniepat »
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