Can You Start Hormone Therapy After 60? New Research Says Yes — For Many Women

Let’s Review the Data.

For years, many women have been told that hormone therapy (HT) — also known as menopausal hormone therapy (MHT) — is only safe to start before age 60 or within 10 years of menopause. This advice came from early findings of the Women’s Health Initiative (WHI) study, which raised concerns about heart disease, stroke, and dementia.

The result? Countless women with bothersome menopausal symptoms — or those looking for bone protection — were told they were “too late” for hormone therapy.

But new research is challenging this old rule. A 2025 review in The Lancet Diabetes & Endocrinology looked closely at WHI follow-up data and other studies — and the findings are encouraging.

Myths vs. Facts About Starting Hormone Therapy After 60

Myth: “You can’t start hormone therapy after age 60 or more than 10 years after menopause.”
Fact: Later starts did not increase heart disease, cardiovascular death, or all-cause death in the Women’s Health Initiative (WHI) follow-up studies.

Myth: “Hormone therapy will cause a heart attack if you start it later.”
Fact: No increased heart disease risk, except a limited increase when combined estrogen + progestin (CEE + MPA — > these are not bioidentical hormones) was started 20+ years after menopause.

Myth: “Older women have a much higher blood clot risk from HT.”
Fact: Clot risk from CEE + MPA was similar in older and younger women; synthetic estrogen alone (CEE) did not significantly raise clot risk.

Myth: “If you start hormones after 60, you will definitely have a stroke.”
Fact: Slightly higher stroke risk in women 60–69 during treatment, but not seen in long-term follow-up.

Myth: “Hormones cause dementia in all older women.”
Fact: In women 65+, combined CEE + MPA doubled probable dementia risk during treatment, but estrogen alone did not. There was no increase in dementia deaths long term.

Myth: “Hormones won’t help bones if you start them late.”
Fact: HRT improves bone density and reduces fracture risk even after age 60.

Myth: “All hormone therapy has the same risks.”
Fact: Bioidentical hormones including transdermal estradiol and micronized progesterone may have lower clot and stroke risks.

What This Means for You

If you are still dealing with hot flashes, night sweats, vaginal dryness, poor sleep, or are concerned about bone health — it may be worth revisiting the conversation about hormone therapy.

The safest and most effective plan depends on your personal health profile. In many cases, options like transdermal estrogen (skin patches, gels, or sprays) paired with the right type of progesterone can help reduce risks while still giving symptom relief and long-term bone protection.

The Bottom Line

The strict “age 60 or 10 years since menopause” rule may no longer apply for everyone. Decisions about hormone therapy should be based on your individual risks and goals, not just your birthday.

Ready to Talk About It?

If you’ve been told you’re “too late” for hormone therapy — it’s time to take another look.

Book a visit today: www.kultivatewomenshealth.com/visit

Reference

Taylor, S., & Davis, S. R. (2025). Is it time to revisit the recommendations for initiation of menopausal hormone therapy? The Lancet Diabetes & Endocrinology, 13(1), 69–74. https://doi.org/10.1016/S2213-8587(24)00270-5