Still Flashing at 65? You’re Not Too Late for HRT

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In this episode I break down one of the most frustrating myths I hear in women’s health: that once you reach a certain age — usually 60 or 65 — you’re “too old” to start hormone therapy.

Spoiler alert: that is not true. And it’s long overdue that we challenge the outdated thinking behind it.

I walk you through how this myth started, what the science actually shows, and how a personalized, risk-based approach is what really matters — not your birthday.

Key Topics I Cover:

Where the “Too Old” Myth Started: The 2002 WHI study caused panic, but it was never designed to assess quality of life — and its flawed conclusions about age cutoffs still haunt modern care.
The Real Impact of Stopping HRT After 60: Many women were forced off therapy overnight, leading to a resurgence of symptoms and long-term confusion among providers.
The Truth About Vasomotor Symptoms (Hot Flashes & Night Sweats):
- Can last 7–14 years or more
- Up to 1 in 3 women over 65 still suffer from them
- More severe and long-lasting in African American and Hispanic women
Other Menopausal Syndromes That Persist or Worsen With Age:
- Genitourinary Syndrome of Menopause (GSM): Dryness, pain with sex, urinary symptoms
- Musculoskeletal Symptoms: Joint pain, frozen shoulder, hand stiffness
- Sleep Disruption: Even without night sweats, quality of sleep drops significantly
- Cognitive Decline: Brain fog, word-finding issues, memory trouble — not just “getting older”
Why There’s No Magical Cutoff at Age 60 or 65: Menopause isn’t a finish line — it’s a transition. And most women spend 30–40 years post-menopause. We can’t ignore their needs for half their lives.
What New Data Actually Shows:
- Later follow-ups (13+ years) from WHI show no increased risk of heart disease or death in women 60+ on HRT
- Slight increases in stroke and clot risk only apply to oral estrogen — not safer, modern non-oral methods
- Estrogen-alone therapy may reduce risk of dementia-related death
- Cognitive data still evolving — but timing, route, and type of hormone matter
Why a Personalized Risk-Benefit Approach Is Critical: Your chronological age isn’t enough. I look at:
- Bone density
- Heart and brain health
- Sleep quality
- Symptom burden
- Family history
Final Takeaway: If you're being told you can't continue or start hormones because of your age — challenge it. Ask why. And if your provider can’t answer, find one who can.

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