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Dr. Andrew Rynne

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Use of hormone replacement therapy after 65 years of age

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Dr. Hema Yadav

Pediatrician, Infectious Diseases

Practicing since :2005

Answered : 1528 Questions

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Posted on Wed, 9 Jan 2013 in Thyroid Problem and Hormonal Problems
Question: Is HRT ever used for the over 65s in Ireland?
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Answered by Dr. Hema Yadav 3 hours later
Hello,
Thanks for posting your query.
In XXXXXXX the life expectancy for women is estimated to be 79 years. This means that the average woman lives for at least 30 years after menopause, a phase of life often associated with increasing rates of chronic illnesses, including cardiovascular disease (CVD), osteoporosis, cognitive decline and cancer.HRT) has been used for many decades in the management of menopausal symptoms and in the prevention of osteoporosis. It was thought to be protective against CVD. but recent studies have suggested an increased risk of CVD with certain forms of HRT especially in older women (>65 yrs).
So as of now starting HRT in above 65 yr old women is not recommended especially if there is no significant indication for the same.
I assume you want to start HRT and considering your age you do fall in the high risk group ( for CVD and cancer). So kindly do discuss it with your gynaecologist as individual assessment is the basis for such a decision rather than general guidelines.
Hope I have answered your query.
I'll be available for any follow up queries.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Hema Yadav 1 hour later
The form I had in mind would be patches. My GP says they are UN natural. I've fractured, two bones, my leg this year, have raised cholesterol, urinary problems, Breathlessness and sleep apnea. Is there a simple test to see if my hormone levels are extremely low for my age? I am deeply reluctant to start taking the many medications that have been suggested.
doctor
Answered by Dr. Hema Yadav 6 hours later
Hello,
Thanks for the follow up.
Because hormone levels may fluctuate greatly in an individual woman, even from one day to the next, hormone levels are not a reliable method for diagnosing menopause. However since you are definitely post menopausal , the blood hormone levels like blood FSH and Blood estrogen levels can be measured to confirm the same .
For osteoporosis risk your blood vitamin d levels ( cholecalciferol ) may also be measured .
I understand your concern as a health conscious individual however your doctor might be right in not recommending HRT in your case considering the risk of heart disease / stroke and cancer in your age group with HRT ( even patches).
He might not have advised you hormone levels because most probably they will be abnormal ( ie in post menopausal range ) but that doesn't mean that HRT would be definitely beneficial to you or worth the risk .
Still you can go ahead with the blood tests for corroborating the diagnosis .As for the alternate treatments for osteoporosis, there are many who do get benefited by them too. The choice between HRT or alternate therapies can be best made by your treating physician after thorough evaluation of your past and present medical history and examination .
Hope I have answered your query.
I'll be available for any further queries.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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