Groundbreaking Study Shatters Myths About Hormone Replacement Therapy for Women Over 65
Menopause symptoms don’t magically disappear as we age. In fact, many women continue to struggle with them well into their 60s, 70s, and beyond. Yet, family practice physicians, OB/GYNs, and primary care doctors often hesitate to prescribe hormone replacement therapy (HRT) to women over 65. Age is frequently seen as a barrier to HRT use, but emerging studies prove this thinking is outdated. Let’s dive into the latest research and discuss why HRT is not just safe, but essential for older women who want to safeguard their health and longevity.
The Persistent Impact of Menopause Symptoms
As women, we spend up to ½ our lives in a menopausal state. Arriving at menopause doesn't always end the discomfort of hot flashes, night sweats, and insomnia. In many cases, they remain as intense or even worsen. This ongoing discomfort can affect mental health, physical health, and overall well-being. Symptoms like vaginal dryness, sexual discomfort, and urinary issues often escalate over time. These symptoms can persist for decades, significantly impacting quality of life.
A client of mine named Carol, age 59, had struggled with osteoporosis and other menopausal symptoms for three years while trying to find a provider willing to prescribe HRT, when we first met. Misconceptions about the risks and benefits of HRT for older women create unnecessary hurdles for Carol and countless others.
Breaking Down the Latest Research
In April of 2024, a groundbreaking study involving over 10 million US women aged 65 and older, recently published in the journal Menopause, provided new insights into the effects of HRT on older women. This was the largest study ever run on women taking hormone replacement therapy, and it is significant that it was conducted by the NIH and the National Library of Health. Contradictory to popular belief, this research highlights significant benefits and minimal risks associated with continued HRT use.
Estrogen Therapy: A Game-Changer in Cancer Prevention
Key Findings from the Study:
- Longevity: Women taking estradiol alone experienced a 21% decrease in all-cause mortality compared to those not on HRT. That’s a 21% lower death rate from any cause!
- Cancer Protection: Estrogen therapy statistically reduced the risk of five cancers—breast, ovarian, uterine, lung, and colorectal.
- Heart and Cognitive Health: Estrogen therapies reduced the risk of severe heart issues (like congestive heart failure, venous thromboembolism, atrial fibrillation, and acute myocardial infarction) and cognitive issues, including dementia.
Estrogen use statistically reduced the risk of all cancers studied, including breast cancer. Every form of estrogen therapy was protective against breast cancer.
Delivery Methods Matter
Older women did best with topical and vaginal deliveries of estrogen, with vaginal delivery being the ultimate best. Both methods effectively protected against breast cancer and supported brain health without the increased stroke risk seen with oral estrogen. Oral estrogen had a slight increased risk of ischemic stroke but offered the best breast protection.
Addressing Breast Cancer Concerns
The study showed that all forms of estrogen therapy were protective against breast cancer. However, combining estrogen with synthetic progestins increased the risk of breast cancer by 19%, while combining it with natural progesterone (oral) only increased the risk by 10%. Notably, lower dosages and vaginal delivery of estrogen did not show any increased risk of breast cancer in any study. Topical bioidentical progesterone showed no increase in risk of cancer alone or with estrogens.
Additional Findings
- Progesterone Use: Bioidentical Progesterone, when used alone, was associated with a 10% reduction in breast cancer risk, but progestin (synthetic) increased the risk by 21%.
- Lung Cancer: Progesterone was associated with a 19% reduced lung cancer risk, while progestin was associated with a 14% increased risk.
- Multiple Benefits: The study highlighted reduced risks of three cancers (breast, lung, and colorectal), four cardiovascular conditions (congestive heart failure, venous thromboembolism, atrial fibrillation, and acute myocardial infarction), and dementia with estrogen replacement or combined estrogen and progesterone replacement. .
Estrogen Therapy Beyond 65
Perhaps the most profound finding was that the use of estrogen therapy beyond age 65 was associated with a significant 19% reduction in mortality from any cause.
Older women on estrogen therapies lived statistically longer and healthier lives.
The Women's Health Initiative: Correcting the Record
The Women’s Health Initiative (WHI) was the original study that created widespread, undeserved alarm by falsely correlating estrogen use to breast cancer due to misinterpreted data and flawed study design. The study was not designed to look at cancer risk– it was originally designed to look at the impact of hormone replacement on cardiovascular risk, and examined only synthetic hormones. The study didn’t control for factors like smoking, past hormone use, and other risk factors compared to the test group, and also didn’t distinguish prior use of synthetic hormones like progestins–now known to be a risk factor for cancer. Subsequent reanalysis and the WHI post-intervention study reported a significant 21% decreased risk of breast cancer with conjugated equine estrogen alone and a 28% increase with conjugated equine estrogen plus medroxyprogesterone (synthetic progestins), giving credence to our current understanding.
Author's Conclusions: Groundbreaking Findings
Here’s what the authors of the 10 million women study concluded: "Our study suggests the possibility of important health benefits with use of menopausal HT beyond age 65 years."
"The use of Estrogen therapy can protect against risks of all-cause mortality, developing cancers (breast, lung, and colorectal), congestive heart failure, venous thromboembolism, atrial fibrilation, acute myocardial infarction (heart attack), and dementia."
The study also noted that the use of combined estrogen and progestin therapy does not increase risks for almost all conditions but does increase the risk of breast cancer. However, low doses of transdermal and vaginal estrogen/progesterone combination therapy (especially E+ bioidentical progesterone) can mitigate this risk. In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with E2 (bioidentical estradiol) rather than Conjugated Equine Estrogren (synthetic) as emphasized by others.
Conclusion
Women over 65 are still experiencing hot flashes and other menopause symptoms. Turning 65 doesn’t mean these symptoms magically disappear or that women no longer need hormone optimization. Going without hormones from the onset of menopause for 10-15 years or longer may allow serious health risks to increase, especially for cardiovascular disease and osteoporosis. Seeking trained, experienced hormone optimization specialists is essential in order to get help from practitioners who understand the nuances of hormones and health risks and how to navigate them effectively. The latest findings offer a hopeful and potentially life-changing perspective. Working with an informed practitioner who understands the science and delivery methods can help you navigate the best options for your health and longevity.
FAQs
What is hormone optimization?
Hormone optimization is the process of ensuring that hormone levels aren’t too high or too low but are “just right.” Just-right hormone levels reduce or eliminate menopause symptoms (some of which can persist for decades) and reduce long-term health risks (like heart disease and osteoporosis).
Is it safe to start HRT after 65?
Absolutely. A study involving 10 million women on HRT showed that HRT past 65 is not only safe but essential for a longer, healthier life.
When should women start HRT?
While the recent study focused on women aged 65 and older to highlight the benefits of HRT later in life, other research indicates that starting HRT earlier can offer additional advantages, particularly for brain health. Studies show that beginning HRT during the perimenopausal transition, specifically five or more years before actual menopause, can significantly reduce the risk of Alzheimer's disease by 50%. This brain-protecting effect diminishes once a woman reaches menopause, emphasizing the importance of timely intervention. The earlier you start, the greater the benefits, and longer use helps mitigate progressive issues like changes in brain volume, heart risk, and bone loss. Additionally, starting HRT early can help prevent the weight gain often associated with perimenopause when combined with appropriate nutrition and exercise. By initiating HRT before menopause, women can not only alleviate menopausal symptoms but also safeguard their cognitive health and overall well-being for the future.
References
- Menopause. "Use of menopausal hormone therapy beyond age 65 years and its effects on women's health outcomes by types, routes, and doses." PubMed
- Brinton, R. D. "Association of Hormone Therapy With Risk of Alzheimer Disease in Women." JAMA Neurology
- Jensen, L. B., Vestergaard, P., Hermann, A. P., Gram, J., Eiken, P., Abrahamsen, B., Brot, C., Kolthoff, N., Sørensen, O. H., Beck-Nielsen, H. "Hormone Replacement Therapy Dissociates Fat Mass and Bone Mass, and Tends to Reduce Weight Gain in Early Postmenopausal Women: A Randomized Controlled 5-Year Clinical Trial of the Danish Osteoporosis Prevention Study."
- Yüksel, H., Odabaşi, A. R., Demircan, S., Karul, A., Kozaci, L. D., Köseoğlu, K. "Effects of oral continuous 17β-estradiol plus norethisterone acetate replacement therapy on abdominal subcutaneous fat, serum leptin levels and body composition." Pages 381-387 | Received 12 Dec 2005, Accepted 05 Jun 2006, Published online: 07 Jul 2009.
- Gambacciani, M., Ciaponi, M., Cappagli, B., Piaggesi, L., De Simone, L., Orlandi, R., Genazzani, A. R. "Body Weight, Body Fat Distribution, and Hormonal Replacement Therapy in Early Postmenopausal Women." The Journal of Clinical Endocrinology & Metabolism, Volume 82, Issue 2, 1 February 1997.
- Espeland, M. A., Stefanick, M. L., Kritz-Silverstein, D., Fineberg, S. E., Waclawiw, M. A., James, M. K., Greendale, G. A. "Effect of Postmenopausal Hormone Therapy on Body Weight and Waist and Hip Girths." The Journal of Clinical Endocrinology & Metabolism, Volume 82, Issue 5, 1 May 1997.
Solutions for a Thriving Sex Life: Vaginal Dryness and Low Libido During Perimenopause🔥💜
Perimenopause, the years leading up to menopause, can sneak up on you and throw your sex life for a loop. You might start noticing some changes down there, like dryness, irritation, or discomfort during sex. And let's be real, it's not exactly a topic that comes up often in casual conversation, leaving many of us feeling alone and unsure of what to do.
I can't tell you how many women have confided in me about their concerns over their dwindling sex drive and how it's impacting their relationships. They love their partners to pieces and are happy in their marriages, but that urge to rip each other's clothes off just isn't there like it used to be. When things do get steamy, it can be harder to get turned on, and even when you do, orgasms might feel like a pale imitation of their former glory. If you're nodding along right now, trust me, you're not the only one, and there are plenty of solutions to help you get your groove back.
First things first, let's get one thing straight: your pleasure and comfort should never take a backseat. You deserve to feel sexy, satisfied, and fulfilled, no matter where you are in life. And the good news is, there are tons of tools and techniques out there to help you do just that. When you make your sexual well-being a priority and embrace pleasure, it can have an amazing ripple effect on every part of your life – your relationships, family, career, and how you feel about yourself.
So, where do you even begin? Allow me to introduce you to some game-changers that are backed by science.
If you're looking to give your vaginal health a boost, Joylux is definitely worth checking out. This innovative device uses LED light therapy, sonic vibration, and therapeutic warmth to rejuvenate vaginal tissue, increase natural lubrication, enhance sexual pleasure, and give your confidence a major boost. Plus, a study in the Journal of Cosmetic and Laser Therapy found that low-level light therapy significantly improved vaginal health in postmenopausal women by increasing collagen production and promoting tissue regeneration. Pretty cool, right?
So how does shining light where the sun doesn't shine, work, exactly? By encouraging the growth of new capillaries, Joylux boosts blood flow, sending a surge of nourishing nutrients to tissues that need it most. The soothing warmth of the device relaxes you while stimulating circulation, reaching a comfy 42°C (108°F) during the 12-minute session. Joylux also kickstarts collagen production, helping to restore elasticity and natural lubrication to your vaginal walls.
Most women start noticing changes within just 3 weeks of consistent use, with the full "wow" effect hitting around the 6-8 week mark. To keep those good vibes going, maintenance sessions 1-2 times a week are all you need.
Now, let's talk options. Joylux comes in two flavors: the standard Vfit Gold and the souped-up Joylux Plus. The Plus model takes things to the next level with: A full 12-minute session 32% more power for faster results A variety of vibration patterns to customize your comfort While both models deliver the goods, the Plus is like the first-class ticket to vaginal rejuvenation. Best part? When you buy through a medical professional or use our special affiliate code, you'll get the Joylux Plus with the programming upgrade included – a $99 value, on the house! Just get in touch with us for the code and the scoop on the free perks. 💡So, are you ready to shine a light on your intimate health? With Joylux, you can rediscover the joy of comfort, confidence, and satisfaction in the bedroom and beyond. Your vagina deserves this – trust us. 💎 Order Joylux devices here.
For those of you who want to tone up your pelvic floor (and trust me, you do), Perifit is a smart little device that connects to an app, turning pelvic floor exercises into a game.
It syncs up with an app on your phone, transforming those sometimes tedious kegels into interactive challenges that'll have you eager to crush your high score. But Perifit isn't just about fun and games – it's a serious tool for boosting your pelvic health. A strong, toned pelvic floor is like a secret superpower for your lady bits.
It can:
👍Improve bladder control (helpful when jumping on trampolines with your kids!)
👍Reduce the risk of pelvic organ prolapse
👍Rev up your sexual function by increasing blood flow and sensitivity in all the right places
And the best part? You'll actually look forward to your pelvic floor sessions–and do them. No more setting reminders or forcing yourself to do those exercises – with Perifit, you'll be jumping at the chance to level up your strength and have a blast doing it. It's time to say goodbye to the days of lackluster kegels and hello to a revolutionary approach to pelvic health. Perifit isn't just a device – it's a game-changer. It's your personal trainer, your cheerleader, and your secret weapon all rolled into one adorably addictive little package.The more you play, the stronger your pelvic floor gets, which can lead to better bladder control, increased sexual sensations, and improved intimate wellness overall. And if you need more convincing, a 2018 study in the Journal of Sexual Medicine found that pelvic floor muscle training significantly improved sexual function in women with pelvic floor disorders.
When it comes to toys, not all are created equal. These little bundles of joy can take our solo or partnered play to a whole new level, but did you know that not all toys are created equal? A 2006 study by the Danish Environmental Protection Agency found that many sex toys contained harmful chemicals like phthalates, which can mess with your hormones and cause irritation. No, thank you. Many conventional sex toys contain sneaky chemicals like BPA, phthalates, TPE, fake silicone, and other toxins that can leach into our delicate vaginal tissue. And trust me, that's not the kind of "tingling sensation" we're looking for!
These chemicals can mimic estrogen in our bodies, throwing our endocrine system out of whack and potentially leading to some seriously uncool reproductive health issues.
But don't worry, you don't have to kiss your beloved buzzing besties goodbye! There are plenty of body-safe options out there that prioritize your pleasure AND your health. Brands like Lelo, Fun Factory, and Dame offer a tantalizing array of toys made from medical-grade silicone, ensuring safety and sustainability without sacrificing any of the toe-curling goodness.
So, how can you tell if a toy is safe? Look for materials like:
👉Medical-grade silicone
👉Borosilicate Glass
👉Stainless steel
These non-porous materials are easy to clean and won't hang onto any icky bacteria or toxins that could crash your pleasure party. Order here.
If you're looking for a luxurious way to pamper your lady bits, Julva, a vulvar cream containing DHEA, could be your new best friend. We'll spend hundreds of dollars on creams and serums for our face and body, but when it comes to our most intimate area, we tend to neglect it. That's where Julva comes in – it's like a daily dose of nourishment for your delicate vulvar skin and vaginal canal. This luxurious cream is packed with DHEA, a hormone precursor that our bodies naturally convert into estrogen and testosterone right where we need it most.
Julva helps by:
👉Boosting moisture levels
👉Improving skin resilience
👉Enhancing sensitivity
👉Less dryness and irritation
👉More comfort during sex and daily life
👉Increased sensation and orgasmic potential
Julva is all-natural, hormone-free, and backed by scientific research. It's like giving your vulva a superfood smoothie, but without the kale-in-your-teeth part (joking). It can help restore moisture, improve skin texture, enhance sensation, and increase intimate comfort. A 2018 pilot study in the Journal of Drugs in Dermatology found that daily application of a DHEA-containing cream significantly improved vaginal dryness, irritation, and discomfort in postmenopausal women. Order Julva here
And if you really want to bring out the big guns, AnteAGE VRS, a cutting-edge serum containing growth factors derived from stem cells, can help revitalize aging vaginal tissue at the cellular level. This powerhouse product can rejuvenate vaginal tissue, increase lubrication, enhance sexual sensation, and improve overall vaginal health. A 2019 study in the Journal of Clinical Medicine found that stem cell-derived growth factors significantly improved vaginal health in postmenopausal women, including increased epithelial thickness, reduced pH, and enhanced lubrication. Please contact [email protected] to order AnteAGE VRS.
If dryness, low sensation, and discomfort are putting a damper on your sex life, allow me to introduce: low-dose vaginal estrogen. 🙌 This little miracle worker comes in the form of a transdermal gel, creams, or suppositories , and it's like a targeted moisture bomb for your V. By delivering a dose of estriol and estradiol right where you need it most, vaginal estrogen can:
💃Restore thickness and elasticity to vaginal walls
💃Boost natural lubrication (goodbye, sandpaper sensation!)
💃Reduce irritation and discomfort
💃Make sex feel amazing again (hallelujah!)
And the best part? If you look back at my reel from last week, you’ll see that the most current data clearly demonstrates that estrogen replacement reduces your risk of 5 types of cancers, including breast cancer, and also increases longevity in women.
Now, I know what you're thinking – "But isn't estrogen therapy risky?" Well, when it comes to vaginal estrogen, the doses are really low. And when managed by a trained practitioner who knows how to optimize your hormone receptors and make sure you’re metabolizing hormones correctly, estrogen can help keep your brain, your bones, your cardiovascular system, and your metabolism on lock– for life. So, if you're battling with menopausal symptoms don't suffer in silence. Let’s talk about if vaginal estrogen is right for you. Your vagina (and your sex life) will thank you. These topical hormones work by restoring vaginal tissue thickness and elasticity, and a 2019 meta-analysis in JAMA Internal Medicine concluded that vaginal estrogen therapy effectively treated vaginal symptoms in postmenopausal women, with minimal systemic absorption.
This is just one aspect of the work I do with women in perimenopause. In my Reverse-Age Method 6-month group program, I utilize a proprietary science-backed 3-step system that I call Balance (hormones), Clear (gut health and cellular detoxification), and Empower (mitochondrial optimization and muscle as medicine). This lab-based program includes personalized nutrition and personal training programs, as well as bespoke custom protocols for each of the three systems, tailored to the specific needs of each woman. In addition to addressing weight gain, skin aging, energy/mood/brain issues, and hormone symptoms like flashes, sweats, and crazy periods, libido and sexual wellness are never put on the back burner in this program!
If you're interested in learning more about the Reverse-Age Method or my Hormone Balance Quick Start program (a 3-month, lower-investment option), I encourage you to book a discovery call with me. Together, we can explore how these programs can help you reclaim your vitality, confidence, and passion for life.
At the end of the day, this journey is all about reconnecting with your body, your pleasure, and your inherent sexual power. It's about having open, honest conversations about vaginal well-being and refusing to settle for anything less than the mind-blowing intimacy you deserve.
So go ahead and explore these transformative tools, knowing that they're grounded in scientific research and designed with your unique needs in mind. Play around and discover what works best for your body and desires. And remember, you're not alone in this. By prioritizing your pleasure and intimate well-being, you can tap into a whole new level of confidence, energy, and fulfillment in every aspect of your life.