Hormone Therapy Over Age 65

Although using hormone therapy in women over age 65 remains controversial, based on a 2016 statement from North American Menopause Society (NAMS) & National Institute for Health (NIH) there are some guidelines providers can follow when advising this population. Most insurance will deny hormone therapy after age 65, however, there are medical standards for using hormone therapy after age 65. This article discusses an 80-year-old patient with clinically justified diagnostic findings that allowed for hormone Rx. Providers will often need to send a letter of clinical justification when patients over 65 meet the medical standards for hormone therapy. NAM’s stance is that age should NOT dictate whether a woman receives hormone therapy, but rather a checklist of genetics, past history, and symptoms should guide the need.

The following populations show greater risk with hormone therapy: https://www.nia.nih.gov/health/hot-flashes-what-can-i-do#risks

Current or past history of:

  • Breast or uterine cancer or family history of same
  • Stroke or heart disease, or family history of same
  • Smokers
  • Blood clots
  • Bleeding disorders
  • Liver disease
  • Allergic reactions to hormones
  • Currently pregnant or considering pregnancy

Risks of taking hormones include:

  • Heart attack
  • Stroke
  • Blood clots
  • Breast cancer
  • Gallbladder disease
  • Dementia

Providers are encouraged to discuss hormone options and discuss risks with patients before prescribing.