Every woman goes through menopause at some point in her life, and it’s common knowledge that during the years leading up to menopause the ovaries produce less and less estrogen – the “female hormone.” With the drop in production of this hormone, unwelcome side effects, such as vaginal dryness and hot flashes, can occur, along with a plethora of other uncomfortable symptoms. As a result, many women choose to undergo a process called hormone replacement therapy (HRT).
HRT can ease many of the symptoms associated with menopause and protect against conditions like osteoporosis and fracture. But the therapy may be associated with potential complications such as blood clotting, breast or uterine cancer, and stroke.
A woman’s risk for these complications varies depending on several factors, but studies point to one key factor that increases risk: age. Let’s find out why hormone replacement therapy is best initiated before age 60–and why being older doesn’t mean you can’t start using HRT.
When is the ideal age to start HRT?
There’s no “ideal age” to begin hormone replacement therapy, but there is an ideal time window–it’s generally thought that HRT is best started before age 60 or within ten years of the onset of menopause. Many women even opt for HRT in their 30s and 40s, as symptoms of perimenopause often set in around that time.
There are several reasons why it’s best to begin hormone replacement therapy earlier rather than later. Studies show that women who start HRT at a younger age can reduce their risk of age-related health conditions like Alzheimer’s disease and diabetes. One large study found that HRT “significantly reduced” the risk of coronary heart disease–but the greatest benefits were shown when initiated before age 60. The scientific consensus seems to be that earlier is better when it comes to starting HRT.
However, if you’re older than 60, that doesn’t mean it’s too late.
Starting HRT after 60: Risks and benefits
It’s true that choosing to begin hormone replacement therapy after age 60 can raise your risk for numerous health conditions such as heart disease, stroke, and breast cancer. But it can also be the only relief for symptoms often experienced years after menopause, like weight gain, insomnia, mood changes, and bone density loss. What’s the best course of action to take?
The topic is indeed a controversial one. Today, most doctors agree that HRT involves a risk-benefit analysis. The risks and benefits involved vary depending on the individual, so the decision on whether to start HRT or not can be complicated. Fortunately, many of the risks involved with HRT can be mitigated by taking smaller amounts of medication, making healthy lifestyle choices, and attending frequent follow-up appointments to make sure you’re in good shape.
So if you’re over 60 and still suffer from postmenopausal symptoms, don’t rule out HRT. Have a thorough discussion with your doctor, weigh the pros and cons, and decide what’s right for you.
Written by Natan Rosenfeld