Menopause Hormone Therapy For Those Over 60
April 3, 2025 • Written by Dr. Hannah WEbb, ND
Menopause and hormone therapy are having a moment—and rightfully so. Conversations around menopausal hormone therapy (MHT) are increasing, shedding light on its potential benefits for quality of life and long-term health. While not for everyone, MHT can significantly improve menopausal symptoms and offer protective effects for bone and heart health.
A brief history: From the 1970s to the 1990s, estrogen was one of the most widely prescribed pharmaceutical products. However, the Women's Health Initiative (WHI), a large-scale study in the 1990s, raised concerns about potential risks, leading to a dramatic reduction in MHT prescriptions in the early 2000s. Over the past 20 years, researchers have reanalyzed this data, leading to a more nuanced understanding of when and how MHT can be safely used. Further research has added to our knowledge. And, we now recognize that the quality-of-life benefits of MHT are significant and should be considered in decision-making. As a result, there has been a recent significant resurgence in its use. There is so much more to be said here of course, but for the purposes of this article I want to focus on women over 60.
There is an entire generation of women for whom MHT treatment through the perimenopause transition was missed. Who could have benefitted from MHT but because of the prevailing perspectives of the past few decades were not offered this therapy as an option. For many women over 60, symptoms of menopause have resolved, but others still experience hot flashes, night sweats, vaginal dryness, sleep disturbances, and more. Additionally, concerns about osteoporosis and heart health may prompt interest in MHT. Given the historical hesitancy to prescribe hormones, many women missed the opportunity for treatment during perimenopause and may now wonder if it is too late to start.
Just in the past 6 months multiple journal articles have been published on this topic. The quick summary is this: age alone does NOT disqualify you from starting MHT, nor is there a mandatory age at which to stop. The decision should be based on a personalized risk-benefit analysis with a knowledgeable provider. Some forms of MHT have a better safety profile than others. Specific treatments for vaginal dryness or pain with intercourse have very few contraindications – most people will qualify for this treatment if they desire it. Because of the dramatic and recent evolution in this field if your provider has not done continuing education about MHT in the past few years their information is likely out of date and you may wish to seek care with a different provider.
MHT is not a one-size-fits-all solution, but it is a conversation every woman should have because very few health choices one can make can have the same degree of impact on quality of life and long term health outcomes. In a healthcare system that has historically underserved women, access to accurate information and appropriate treatment is an essential, feminist issue.