Have you been told no to hrt if you are 10+ years post menopause?

@kfhoz That is interesting that your dr is a proponent of estrogen for osteoporosis. Wow. Even if you are 10 yrs out of menopause? I'm very leery of the osteoporosis drugs but as of now, the answer is no for me on estrogen from two drs. One is the head of the gyn department at Mercy. I'm not sure she is up on the latest research tho. I'd be careful not to take oral estrogen either way. You have to take it for your whole life to maintain the protective effect. Good luck to everyone.

@maryandnans That is correct but there are still risks with taking estrogen 10 yrs out. I've been taking oral progesterone for years so hoping that is helping some.

Yes, but both of my Drs are ok with me taking it, because I'm pretty healthy and I do a lot of exercising so they're not worried about any of the other things that can happen possibly
My primary even thought that it would definitely help with my osteoporosis.

@pattiel

Thanks for sharing your thoughts. The key in deciding on HRT is individualized risk assessment with shared decision-making.

It’s true that oral estrogen carries different risks than transdermal forms, which is why many clinicians prefer patches nowadays.

From what I understand, there isn’t a strict guideline that prohibits starting HRT more than 10 years post-menopause - timing is a factor, but not an absolute rule. A low CAC score isn’t an automatic stop either; for example, mine was 38, but it was evaluated and deemed safe for me to use HRT. Your PFO though might be a factor that shifts your personal risk–benefit balance.

That said, clinical practice can vary widely, as many members here have seen. When in doubt, getting second opinions could help. I had additional consultations with both cardiology and gyn specialists to make sure HRT was appropriate for me 11 years after menopause. And of course, the endocrinologist managing osteoporosis also has a say in whether HRT is an appropriate option.

All info on this subject has not been a blanket statement saying it’s ok to take HRT 10 yrs after menopause. The many different sites emphasize it’s individualized - for some it’s high risk, because of course there’s many our age with cardiac health issues, and breast cancer family histories, but for some it’s not, and therefore can hold a benefit. Of course , not for all.

@kfhoz thinking of revisiting hrt after a round of Evenity and one year of Prolia. Your second link did nit link to explanation. Was it Dr Lucas? Did he treat you?

From what I understand, there are many aspects affecting extent of one's bone thinning. That large WHI study when analyzed closer, was found to have the cardiovascular disease events occurring mostly in those women who were 10 years past the age of menopause. So now, they are looking at recommendations more closely & 'revisiting.' The following is from the study.

Although the WHI demonstrated increased risk of CVD(cardiovascular disease) events with MHT (hormone therapy) in the overall cohort, subsequent secondary analyses demonstrated that these risks were influenced by the woman's age and time since menopause, with lower absolute risks and hazard ratios for younger than older women.

Review Clin Cardiology. 2018 Feb;41(2):247-252. doi: 10.1002/clc.22891. Epub 2018 Mar 1.
What the Women's Health Initiative has taught us about menopausal hormone therapy
Rebecca C Chester 1, Juliana M Kling 2, JoAnn E Manson 3
Affiliations Expand
PMID: 29493798 PMCID: PMC6490107 DOI: 10.1002/clc.22891
Abstract
Our understanding of the complex relationship between menopausal hormone therapy (MHT) and cardiovascular disease (CVD) risk has been informed by detailed analyses in the Women's Health Initiative (WHI), the largest randomized, placebo-controlled trial evaluating MHT in postmenopausal women. Although the WHI demonstrated increased risk of CVD events with MHT in the overall cohort, subsequent secondary analyses demonstrated that these risks were influenced by the woman's age and time since menopause, with lower absolute risks and hazard ratios for younger than older women. As MHT is the most effective treatment for the vasomotor symptoms of menopause, it is important to understand its risks and how to conduct risk stratification for symptomatic women. In addition to reviewing the WHI findings, studies pre- and post-WHI are reviewed to describe the relationship between MHT and CVD risk in menopausal women. The absolute risks of adverse cardiovascular events for MHT initiated in women close to menopause are low, and all-cause mortality effects are neutral or even favorable for younger menopausal women. The WHI has advanced and refined our understanding of the relationship between MHT and CVD risk. Although MHT should not be used for CVD prevention, absolute risks of CVD are low when MHT is started close to menopause in healthy women and hazard ratios tend to be lower for younger than older women. For women in early menopause and without contraindications to treatment, the benefits of MHT are likely to outweigh the risks when used for menopausal symptom management.

Keywords: Acute Coronary Care; Cardiovascular Risk; Menopausal Hormone Therapy; Women's Heart Disease; timing hypothesis.

© 2018 Wiley Periodicals, Inc.

I am enjoying this discussion and all that I am learning here.

First of all the study was flawed and now they say no HRT after 10 years. I don't believe them. Just follow your doctors advise.

@gretch19 My doctors are part of a semi-HMO-like organization in the Seattle area that only takes patients 65+ years of age. Both seem super smart and up-to-date and one of them has published papers.

Sorry that my link to the article on YouTube did not work. It was to one of Dr. Doug's videos. I like the way that he sometimes picks one or two research papers and reviews in detail including specific excerpts. I always also read the paper and look for similar research.

In case you want to find it the title was "NEW: Study Shows Jawbone Death Risk 11X Higher Than Reported [Doctor Explains]"