HRT for Women after 65 yo
Natalia Poleschuk • May 21, 2025
How Hormone Replacement Therapy Could be Beneficial to Felmaes over 65 yo.
Is Hormone Therapy Safe After Age 65?
What You Need to Know About Bioidentical Hormones
Hormone therapy (HT) has come a long way in recent years. If you're a woman over 65 and wondering whether it's safe—or even beneficial—to start estrogen and progesterone, the answer is: it depends. Here's what the latest science says.
โ What Are Bioidentical Hormones?
Bioidentical hormones are molecularly identical to the ones your body naturally produces. The most common types include:
- Estradiol (E2) – found in patches, gels, and creams
- Micronized progesterone – often used in capsule form (Prometrium)
These are different from synthetic hormones like Premarin (conjugated equine estrogen) or Provera (medroxyprogesterone), which are no longer first-line due to safety concerns.
๐ง Benefits of Hormone Therapy (When Appropriately Used)
- Bone health: Helps prevent fractures and osteoporosis
- Brain function: May support memory and cognitive function when started early
- Cardiovascular: May slow artery aging if started before age 60
- Sleep & Mood: Natural progesterone can reduce anxiety and improve sleep
- Vaginal health: Prevents dryness, UTIs, and supports sexual function
โ ๏ธ Is It Safe to Start Hormones After 65?
Most women benefit most when HT is started within 10 years of menopause or before age 60. However, recent research shows that starting bioidentical hormone therapy after age 65 can still be safe—if you're healthy and properly screened.
๐ซ When to Avoid Hormone Therapy:
- History of stroke, heart attack, or blood clots
- Active or past breast cancer
- Poorly controlled blood pressure or diabetes
โ Who May Be a Candidate at Age 70+:
- Healthy, active women with few cardiovascular risks
- Women with severe osteoporosis not responding to other treatments
- Those who previously used HT and want to restart
๐ Safer Hormone Therapy Options:
- Low-dose transdermal estradiol patch & Micronized progesterone at night
๐ฉบ Monitoring:
- Annual mammogram
- Routine labs (lipids, liver, thyroid, electrolytes)
- Bone density and uterine checks if on combined therapy
๐งพ Bottom Line:
๏ปฟ
Hormone therapy after 65 isn't off the table. With the right approach—bioidientical, low-dose, transdermal estrogen plus natural progesterone—many women can safely benefit. The key is individualization, informed consent, and expert monitoring.
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๐ง Brain Estrogen, Progesterone, Testosterone, Thyroid (T3), DHEA Affects: memory, focus, mood, cognition, neurotransmitter balance Low hormones → brain fog, anxiety, depression, poor concentration, dementia risk ๐๏ธ Eyes / Vision Estrogen, Thyroid (T3), Testosterone Maintains: tear production, ocular surface, visual clarity Low estrogen/T3 → dry eyes, blurry vision, light sensitivity ๐ Mouth / Saliva Estrogen, Thyroid Supports: saliva production, oral mucosa, taste Low estrogen → dry mouth, metallic taste, dental issues ๐งโ๏ธ Balance / Equilibrium Estrogen, Progesterone, Thyroid Regulates: inner ear function, vestibular system Decline → dizziness, vertigo, motion sensitivity ๐ฅด Esophageal Sphincter (GERD / Hiatal Hernia) Progesterone, Estrogen Maintains: muscle tone of lower esophageal sphincter Low levels → increased reflux, heartburn, bloating, hernia risk ๐ Breasts Estrogen, Progesterone, Testosterone Affects: tissue tone, density, cancer risk Low estrogen → sagging, tissue thinning Hormone imbalance → fibrocystic changes, higher breast cancer risk if unbalanced ๐งฌ Liver Estrogen, Thyroid, DHEA, Insulin Supports: detoxification, lipid metabolism, bile production Decline → poor detox, fat buildup, sluggish bile flow โค๏ธ Heart Estrogen, Testosterone, Thyroid, DHEA Regulates: cholesterol, blood pressure, vascular tone Low estrogen → higher LDL, plaque buildup, arrhythmias ๐ฌ๏ธ Lungs Estrogen, Progesterone Regulates: respiratory rhythm, CO2 sensitivity Decline → shortness of breath, poor oxygenation during sleep ๐ฌ Pancreas / Blood Sugar Estrogen, Progesterone, DHEA, Thyroid, Testosterone Affects: insulin sensitivity, glucose metabolism Decline → insulin resistance, weight gain, prediabetes/diabetes risk ๐ฝ๏ธ Gallbladder Estrogen, Progesterone Affects: bile flow, motility Low progesterone → bile stasis → risk of gallstones ๐งป Gut / Digestive Tract Estrogen, Progesterone, Thyroid, Cortisol Supports: motility, microbiome, gut lining integrity Decline → bloating, constipation, SIBO, leaky gut ๐ฅ Ovaries FSH, LH, Estrogen, Progesterone, Testosterone Hormone factory pre-menopause Menopause = ovarian hormone production ceases ๐ฆ Thyroid TSH, T3, T4, Estrogen Affects: metabolism, temperature, hair, energy Estrogen decline may unmask hypothyroidism Low T3 → fatigue, weight gain, dry skin ๐ Uterus Estrogen, Progesterone Maintains: endometrial lining, muscle tone Low estrogen/progesterone → uterine atrophy, irregular bleeding Unopposed estrogen → endometrial hyperplasia/cancer risk ๐ช Muscles Testosterone, Estrogen, Thyroid Supports: strength, lean mass, recovery Low T → sarcopenia, loss of tone Low T3 → muscle pain, weakness ๐ฆด Joints / Bones Estrogen, DHEA, Testosterone, Vitamin D Maintains: bone density, joint lubrication Decline → arthritis, joint pain, osteoporosis ๐โ๏ธ Hair Estrogen, Testosterone, Thyroid, DHEA Affects: scalp health, thickness, growth rate Imbalance → thinning, shedding, brittle hair ๐
Nails Thyroid, Estrogen Reflect: nutrient absorption, metabolic health Low T3 → brittle, ridged nails ๐๏ธ๐จ๏ธ Vision / Eye Health Estrogen, Thyroid Dry eye, glaucoma risk increase post-menopause ๐ง Kidneys / Bladder Estrogen, Progesterone, Testosterone Maintains: pelvic floor tone, bladder sensitivity Low estrogen → frequent UTIs, urgency, leakage ๐ง Mood / Mental Health Estrogen, Progesterone, Testosterone, Thyroid, DHEA Modulates: serotonin, dopamine, GABA Imbalance → anxiety, depression, irritability, mood swings
