There Is No Absolute Age Cutoff for Hormone Therapy

Written by

Dr. Kelly Casperson

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on KellyCaspersonMD

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A timely Substack essay challenging outdated age-based limits for HRT and advocating for a personalized approach to hormone health.

1. Hormone Therapy Beyond the “Window“: Dispelling Age Myths

It's time to debunk the myth that hormone therapy is only for younger women. Older women, especially those beyond the so-called 'ideal' window, can still benefit from treatment. Let's shift the focus from age prohibition to the potential benefits of hormone therapy.

It's time to stop pretending that there's some magical age where hormone therapy (HT) suddenly becomes too dangerous to consider. The science doesn't support that fear-based messaging, and in fact, it tells a very different story.

For decades, women who were more than 10 years past menopause were told they were 'too late' for hormones (this usually means estrogen, implying that progesterone and testosterone don’t matter). You are too old. Past the window. Told that hormone therapy was 'only for young menopausal women' and 'not safe after age 60.' But let's be clear: those warnings were based on broad, outdated interpretations of the WHI study - a study that used oral conjugated equine estrogens and synthetic progestins (no longer the gold standard) in women who were already decades into menopause, many with underlying conditions. As the years went on in that study, the 'risks' didn't hold up - most strikingly, the risk of stroke.

The actual truth? It tells a different story. A safer, more nuanced one. Especially when discussing transdermal estradiol, the other hormones, and individualized care.

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