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

Posted by gravity3 @gravity3, May 16, 2024

Starting hrt 10 years post menopause and the flawed Women's health initiative study.
I have been told no and yet the current findings seem to indicate that hrt can still help.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Apparently, new research has been released on estrogen, especially the newer forms, bioidentical instead of estrogen made from horse pee. Maybe there will be hope for some , but we baby boomers missed out, to put it politely. I am angry.

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Profile picture for mayblin @mayblin

@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.

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Thank you, yes, exactly… you have to be pro- active and find out all the info , risk factors and where you are in that scenario. It’s very individual. There are so many new, updated views on this very complex treatment and the former research had to do with Premarin and not the patch which is now considered much less a risk.. since I am 10 yrs post menopause, but low risk in all the other health considerations, my GYN Dr at Yale brought my case to the GYN board there to discuss and the experts on this GYN board overwhelmingly agreed they would start me on HRT ….

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I am 64 and also have started HRT with a functional medicine group as my primary MD was very hesitant. I had no other risk factors and felt with the new information and the use of bio identical forms it was worth it to me.

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Profile picture for blueberre @blueberre

Apparently, new research has been released on estrogen, especially the newer forms, bioidentical instead of estrogen made from horse pee. Maybe there will be hope for some , but we baby boomers missed out, to put it politely. I am angry.

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@blueberre I am so angry too! Baby boomers are the casualty of the WHI. 😡. We weren't offered HRT due to this flawed study...

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Profile picture for mahonlye @mahonlye

Thank you, yes, exactly… you have to be pro- active and find out all the info , risk factors and where you are in that scenario. It’s very individual. There are so many new, updated views on this very complex treatment and the former research had to do with Premarin and not the patch which is now considered much less a risk.. since I am 10 yrs post menopause, but low risk in all the other health considerations, my GYN Dr at Yale brought my case to the GYN board there to discuss and the experts on this GYN board overwhelmingly agreed they would start me on HRT ….

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@mahonlye
What are the other health factors to consider before starting HRT at 10 years post-menopausal?

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Yes, just today I met with a nurse practitioner at my OB/GYN for an open discussion. She said the HRT treatments will do NOTHING to increase bone density for post-menopausal women. She stated to me they are meant to be a "bridge" between peri-menopause and menopause. Funny thing is I DID expect this answer, but I needed to go and rule it out. I asked her about "bio-identical" options and she said they are not FDA approved, so she could not make that recommendation. That being said, she did mention some kind of "bio-tea" she was aware of on Amazon. So far, with my osteoporosis diagnosis in April 2025, I have been going "natural" with diet & exercise. I work with a physical therapist, who incrementally helps me have the confidence to increase the weights I use for deadlifts, squats and assorted other exercises that help you grow muscle, which helps with bone growth. I do believe this is quite a controversial topic for women who are post-menopausal. I'll be checking back to see what others have to say!

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Profile picture for loeschke @loeschke

@mahonlye
What are the other health factors to consider before starting HRT at 10 years post-menopausal?

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@loeschke High blood pressure, untreated.

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Profile picture for smc25 @smc25

I am 64 and also have started HRT with a functional medicine group as my primary MD was very hesitant. I had no other risk factors and felt with the new information and the use of bio identical forms it was worth it to me.

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@smc25 I've checked the websites of 5 functional medicine groups. It seems that they do deal with HRT BUT the cost of visits ranges from $600 to $9,000.

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Profile picture for tillymack @tillymack

@smc25 I've checked the websites of 5 functional medicine groups. It seems that they do deal with HRT BUT the cost of visits ranges from $600 to $9,000.

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@tillymack

My insurance pays for the blood tests and nurse practitioner visits as well as my vaginal estradiol and progesterone capsules. I pay 375 for the estradiol and testosterone pellet and insertion every 12 weeks.

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