HRT in Post-Menopause: The Truth of Menopausal Hormone Therapy After 65

Menopause doesn’t stop at 65—and neither should your options.

For decades, women over 65 have been told to “tough it out.” That hormone therapy is dangerous, unnecessary, or not worth the risk. Meanwhile, the symptoms persist—stealing energy, confidence, and joy—and the silence surrounding MHT grows louder.
But what if everything you’ve been told about hormone therapy is incomplete—or even wrong?

What if the story is far more nuanced, and there’s another side to MHT that no one’s talking about? One that could reshape how we think about health, aging, and vitality after 65.

The truth is, groundbreaking research is shattering old narratives about hormone therapy. But the results aren’t just surprising—they’re life-changing. Could MHT save lives? Protect against cancer? Reduce risk of heart disease? Could it be the key to unlocking the vibrant, fearless life you deserve after menopause?

The answers aren’t what you’d expect.

Let’s uncover the science behind this new wave of menopause care, explore its implications, and connect the dots between hormone therapy, lifestyle strategies, and your well-being.

Professor Kay Bloom, The Menopause Professor of the LifeBloom Menopause Institute and founder of 8 Minute Menopause and the Bloomer Brigade Social Group.
Dr. Kay Bloom, The Menopause Professor

At LifeBloom Menopause Institute, we’ve seen firsthand how science-backed strategies—tailored nutrition, functional fitness, and personalized care—transform lives during menopause and beyond. Our mission is simple: to help you not just survive these years, but thrive like never before.

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The Evolution of Menopausal Hormone Therapy

From Fear to Fact: The Legacy of the WHI Trials

In 2002, the Women’s Health Initiative (WHI) turned the world of menopausal hormone therapy (MHT) on its head. Headlines everywhere declared that MHT increased the risk of breast cancer, heart disease, and stroke. Women were told to stop hormone therapy, and a wave of fear swept through the medical community and the public alike.

But those early conclusions weren’t the whole story. The WHI trials only studied one type of hormone therapy: oral conjugated estrogen (CEE) paired with medroxyprogesterone acetate. This singular approach overlooked the diversity of therapies available, including lower doses, transdermal applications, and natural progesterone. Moreover, later re-analyses showed that many of the risks were overstated and that hormone therapy, when tailored to the individual, could provide substantial benefits.

Why Age 65 Isn’t the End of Menopause Symptoms

For years, the medical community assumed that menopausal symptoms vanished shortly after menopause itself. But research now tells us otherwise. A 2015 study found that vasomotor symptoms, such as hot flashes and night sweats, persist for an average of 7–12 years for many women, and nearly half of women aged 60–65 still experience them. These symptoms don’t just fade into the background; they can disrupt sleep, affect mood, and diminish overall quality of life.

This persistence of symptoms has shifted the perspective on MHT. The North American Menopause Society (NAMS) now emphasizes that there’s no one-size-fits-all rule for stopping hormone therapy at age 65. Instead, they recommend personalized, ongoing assessments to weigh the risks and benefits for each woman.

Today’s Science: A New Lens on Hormone Therapy

A study by Baik et al. (2024) shines a spotlight on the nuanced benefits of MHT beyond age 65.
The findings highlight how factors like the type of hormone (estradiol vs. conjugated estrogen), the method of delivery (transdermal vs. oral), and the dosage (low vs. high) all influence health outcomes.

For instance, low-dose transdermal estradiol significantly reduces the risk of heart disease, breast cancer, and even dementia, without the risks associated with higher-dose oral options.

This growing body of evidence is paving the way for a more balanced and individualized approach to hormone therapy—one that considers a woman’s unique health profile, symptoms, and goals.

 

The Shift Toward Empowerment

The evolution of MHT represents more than just a shift in medical practices; it’s a reclamation of women’s agency over their health.

Women over 65 aren’t just patients—they’re vibrant individuals who deserve options tailored to their needs. Whether it’s through hormone therapy, nutrition, or strength-building exercises, today’s tools can help women thrive well into their golden years.

At LifeBloom, we integrate these tools into every program, empowering women to take control of their menopause journey.

Whether you’re navigating the challenges of perimenopause or exploring options for long-term health, our programs are here to help. Visit our LifeBloom website to learn more or join our thriving Facebook community.

 
Is denying women of HRT robbing them of their health? Why is it hard to get HRT
 
 

Key Findings of the Recent Research on Menopause Hormone Therapy

When it comes to menopausal hormone therapy (MHT) after 65, the data is anything but straightforward. For years, women were told to abandon hormone therapy as they aged, due to fears of increased risks of breast cancer, cardiovascular disease, and other health concerns. But the groundbreaking research by Baik et al. (2024) challenges those assumptions, revealing a more nuanced and hopeful picture of MHT’s benefits—and risks—when tailored to individual needs.

Here’s what the study uncovered:

1 – Reducing the Risk of Mortality

The study found that estrogen monotherapy was associated with a 19% reduction in all-cause mortality compared to women who had never used MHT or discontinued its use after age 65.
This isn’t just a minor benefit—it’s a life-altering statistic for millions of women.
 
Low-dose transdermal or vaginal estrogen proved particularly effective, highlighting the importance of how hormone therapy is administered.

This finding aligns with previous research, such as a meta-analysis published in The Journal of Clinical Endocrinology & Metabolism (2015), which showed that MHT use was associated with a 30% reduction in mortality when started during the early menopausal years and extended into later life.

2 – Cancer Risks and Protection

The relationship between MHT and cancer is often misunderstood, but this study provides much-needed clarity:
  • Breast Cancer:

    While combination therapies using estrogen and progestin or progesterone were associated with a 10–19% increased risk of breast cancer, these risks were significantly lower when low-dose, non-oral forms (like transdermal or vaginal) were used. This aligns with findings from a 2019 study in The Lancet, which highlighted the increased breast cancer risk associated with long-term MHT use but noted the importance of dose and delivery method in mitigating risk.

  • Lung and Colorectal Cancer:

    Estrogen monotherapy was linked to a 13% reduction in lung cancer risk and a 12% reduction in colorectal cancer risk. These results support earlier studies, such as a 2017 report in Cancer Epidemiology, Biomarkers & Prevention, which found lower colorectal cancer rates in women using estrogen-based MHT.

 

3 – Cardiovascular Benefits

Heart health is often a primary concern for postmenopausal women, and this study revealed significant benefits of MHT when used thoughtfully:
  • Congestive Heart Failure (CHF): 

    Estrogen monotherapy and combination therapies reduced CHF risk by 4–5%.

     
  • Venous Thromboembolism (VTE)

    Low-dose transdermal estrogen significantly reduced the risk of blood clots compared to oral forms, which aligns with findings in Circulation (2020), highlighting the safer profile of transdermal therapies.

     
  • Acute Myocardial Infarction (AMI): 

    Estrogen users experienced an 11% lower risk of heart attacks compared to non-users, supporting earlier research published in Menopause (2013), which highlighted the protective cardiovascular effects of low-dose estradiol.

 

4 – Dementia and Cognitive Function

Contrary to previous fears, the study showed that MHT could offer small but meaningful reductions in the risk of dementia, particularly with low-dose estradiol.

This adds to the growing body of evidence, including a 2021 study in Alzheimer’s & Dementia, which found that starting MHT early and continuing it beyond age 65 was associated with better cognitive outcomes.

 
 

The Role of Dosing and Delivery

Not all MHT is created equal. The Baik et al. study emphasized the importance of tailoring therapy to minimize risks and maximize benefits:

  • Low-Dose Therapy: Offered greater health benefits with fewer risks than medium or high doses.

     
  • Transdermal and Vaginal Routes: Outperformed oral options in reducing risks of blood clots, cardiovascular disease, and breast cancer. These findings reinforce recommendations from the North American Menopause Society (2022), which advises non-oral options for older women.

What This Means for Women

These findings challenge the outdated “one-size-fits-all” approach to hormone therapy and highlight the need for individualized care.

While MHT is not suitable for every woman, this research underscores that, when tailored appropriately, it can improve longevity, protect against chronic diseases, and support overall health.

If you’re considering hormone therapy—or wondering if it’s the right choice for you—it’s vital to work with a healthcare provider who understands the nuances of MHT and can personalize your care plan.

At LifeBloom Menopause Institute, we guide women through these decisions with science-backed strategies, integrating MHT with lifestyle changes like hormone-supportive nutrition and functional fitness.

Explore how these tools can work together by joining our community or learning more about our tailored programs here.

 
 
 

Real-World Implications

The findings of Baik et al. (2024) go beyond the realm of clinical trials—they challenge the narrative about what aging, health, and menopause should look like.

For women over 65, these results open doors to possibilities that were previously dismissed. Here’s what this groundbreaking research means in the real world:

 

A New Perspective on Aging and Hormone Therapy

For decades, the default advice has been to stop hormone therapy after 65.

This decision was largely shaped by the results of the Women’s Health Initiative (WHI), which led to widespread fears about increased cancer and cardiovascular risks.

But the new study’s findings, coupled with other recent research, provide an important counterpoint: with the right dose, type, and delivery method, hormone therapy can offer significant health benefits, even in later years.

The 2022 position statement by the North American Menopause Society (NAMS) emphasizes that age alone should not dictate whether a woman continues hormone therapy.

Instead, the focus should be on individual needs, symptoms, and health risks. This shift in perspective empowers women to make informed decisions about their health in consultation with knowledgeable providers.

 

Individualized Care Is Non-Negotiable

The study underscores that not all hormone therapies are created equal.

The route of administration, the type of estrogen or progestogen, and even the dose strength can dramatically influence outcomes.

For example:

  • Transdermal Estrogen: Reduced risks of venous thromboembolism (VTE), heart disease, and stroke compared to oral estrogen, as supported by findings from Circulation (2020).

     
  • Low-Dose Therapy: Shown to maximize benefits while minimizing risks, aligning with recommendations from a 2021 review in Climacteric on tailoring MHT to older women.

     
  • Natural Progesterone: May be a safer option for women concerned about breast cancer risks compared to synthetic progestins, as highlighted in a 2020 meta-analysis in The Lancet.

     
The message is clear: a personalized approach is critical. What works for one woman may not work for another, which is why careful evaluation of symptoms, risks, and preferences is essential.

Reframing Risks and Benefits

Much of the stigma surrounding hormone therapy stems from an oversimplified view of its risks. Yes, certain types of MHT can increase the risk of breast cancer or cardiovascular events, but as this study reveals, the delivery method and dosage make a huge difference. For example:

  • Breast Cancer Risk: While estrogen-progestogen combinations increase risk, low-dose transdermal forms appear to mitigate it, as supported by a 2019 report in The Journal of the National Cancer Institute.

  • Heart Disease: Estrogen monotherapy is linked to a lower risk of heart failure and myocardial infarction, aligning with findings from The New England Journal of Medicine (2017).

Women must move away from fear-based decisions and embrace nuanced discussions about the balance of risks and benefits, particularly when it comes to long-term health.

 
 
 

Beyond MHT: The Lifestyle Connection

While MHT plays a vital role, it’s just one piece of the puzzle. Nutrition, exercise, and lifestyle habits significantly influence how women navigate postmenopause. For example:
  • Nutrition: Diets rich in phytoestrogens, such as those found in soy and flaxseeds, have been shown to support hormonal balance. A study in Nutrition Research Reviews (2021) found that plant-based compounds can enhance the effects of MHT and reduce menopausal symptoms.

  • Exercise: Functional strength training not only supports cardiovascular health but also combats the muscle loss and bone density decline associated with menopause. According to Osteoporosis International (2020), regular resistance training reduces fracture risk and improves mobility in postmenopausal women.

  • Mental Health: Addressing the mental toll of menopause is just as important. Mindfulness practices have been linked to lower cortisol levels and improved mood, as shown in a 2019 study in Menopause: The Journal of The North American Menopause Society.

This integrated approach to health is what we champion at LifeBloom Menopause Institute. By combining science-backed MHT strategies with hormone-supportive nutrition and functional fitness, we help women reclaim their energy and confidence.

Breaking the Silence Around Menopause

One of the most powerful implications of this research is its potential to normalize conversations about menopause after 65. For too long, women have felt silenced or ashamed to discuss their symptoms or seek treatment. This study reminds us that menopause isn’t a time to shrink into the background—it’s a time to take charge.

By sharing evidence-based insights like these, we can help women advocate for their health, push back against misinformation, and demand the care they deserve.

What’s Next?

The findings from Baik et al. are a wake-up call to rethink how we approach menopause in later life. But knowledge alone isn’t enough—it’s time to take action. Whether that means exploring hormone therapy options, adopting a hormone-supportive diet, or incorporating functional fitness into your routine, the tools are here.

At LifeBloom Menopause Institute, we’re dedicated to providing the support you need to navigate this stage of life with confidence.

To explore tailored programs designed specifically for women in perimenopause and postmenopause, visit our LifeBloom website.

The choices you make today can transform your tomorrow. Are you ready to embrace what’s possible? Let’s move forward together.

 
 

The Bigger Picture

These studies paint a consistent picture: MHT is not a one-size-fits-all solution, but it can be a powerful tool for improving longevity, reducing disease risk, and enhancing quality of life when carefully personalized. Whether it’s through reducing mortality, protecting the heart and brain, or mitigating cancer risks, the potential of hormone therapy is undeniable when applied strategically.

At LifeBloom Menopause Institute, we take the latest research and combine it with practical strategies to help women thrive during menopause and beyond. Our approach includes tailored hormone therapy guidance, hormone-supportive nutrition, and functional fitness programs.

The science is clear, and the tools are here. Let’s redefine what thriving in menopause looks like—together.

Integrating MHT with Lifestyle

While the benefits of menopausal hormone therapy (MHT) are compelling, it’s important to remember that hormone therapy is just one piece of the puzzle. True transformation during menopause and beyond comes from an integrative approach that combines MHT with lifestyle strategies that support hormonal balance and overall health.

Here’s how you can optimize your health by combining MHT with lifestyle interventions:

 
 

Nutrition: Fueling Hormonal Health

The food you eat plays a powerful role in how your body responds to hormonal changes. A hormone-supportive diet can enhance the effects of MHT and provide benefits for women who aren’t candidates for hormone therapy.

  • Phytoestrogens: Foods like soy, flaxseeds, and legumes contain natural compounds that mimic estrogen, helping to balance hormones. A 2021 review in Nutrition Research Reviews found that phytoestrogens may alleviate vasomotor symptoms like hot flashes while supporting cardiovascular health.

  • Anti-Inflammatory Foods: Diets rich in fruits, vegetables, omega-3 fatty acids, and whole grains help reduce inflammation, which is linked to heart disease, weight gain, and cognitive decline.

  • Calcium and Vitamin D: Essential for bone health, especially during and after menopause, when the risk of osteoporosis increases.

At LifeBloom, our 8 Minute Menopause Nutrition Workshop provides a simple, science-backed blueprint to reset your metabolism, boost energy, and balance your hormones.

Strength Training: Building a Resilient Body

Hormonal changes during menopause can lead to muscle loss, decreased bone density, and a slower metabolism.

Strength training is a powerful antidote:

  • Muscle Preservation: Resistance exercises prevent the muscle loss that typically occurs during menopause. According to a 2020 study in Osteoporosis International, women who engaged in regular strength training had higher bone density and lower fracture risk.

     
  • Metabolic Boost: Strength training increases resting metabolic rate, helping to combat the weight gain many women experience during menopause.

     

Our 8 Minute Menopause Program at LifeBloom emphasize low-impact, functional strength training to build a stronger, healthier you—no matter where you’re starting.

 

Mental and Emotional Wellness

Menopause can take a toll on mental health, with many women experiencing mood swings, anxiety, or depression. Incorporating mindfulness and stress-reduction techniques can make a big difference:
  • Mindfulness Practices: Research published in Menopause: The Journal of The North American Menopause Society (2019) found that mindfulness meditation reduced stress and improved sleep in postmenopausal women.

  • Community Support: Connecting with others who understand your journey can be transformative. Join our supportive community on Facebook for resources, encouragement, and shared experiences.

Partnering with Your Doctor

The right healthcare provider is an essential part of your menopause journey. Regular assessments and personalized care plans ensure you get the most out of MHT while addressing any concerns or side effects.

By combining MHT with nutrition, exercise, and mental health strategies, you can create a holistic approach to menopause that helps you thrive—not just survive.

Overcoming Barriers

Even with compelling research and transformative potential, many women hesitate to explore menopausal hormone therapy (MHT) or take steps toward a healthier lifestyle. Barriers like fear, misinformation, and lack of support often stand in the way. Here’s how to break through those challenges:

Debunking Myths About MHT

MHT has been surrounded by fear since the 2002 Women’s Health Initiative (WHI) study. While that research initially raised alarms about increased risks, follow-up studies have clarified the findings and highlighted the benefits of low-dose, personalized therapy.
  • Myth: Hormone therapy always increases breast cancer risk.

    Reality: The risk depends on the type, dose, and delivery method of MHT. Low-dose transdermal estrogen, for example, has a much lower risk profile than oral estrogen-progestogen combinations (The Lancet, 2019).

  • Myth: MHT is only for short-term use.

    Reality: As Baik et al. (2024) showed, many women can safely benefit from MHT well beyond age 65 when therapy is tailored to their needs.

Advocating for Yourself

Navigating the healthcare system can be challenging, especially when discussing menopause. Many doctors lack updated training on the latest menopause research. Here’s how to advocate for yourself:
  • Be Informed: Arm yourself with research like the Baik et al. study and other credible sources.

     
  • Ask Questions: Don’t hesitate to ask your doctor about low-dose and non-oral MHT options or seek a second opinion.

     
  • Seek Specialists: Consider consulting a menopause specialist who understands the nuances of hormone therapy.

 

Combatting Misinformation

The internet is full of conflicting advice about menopause and MHT. To cut through the noise:
  • Stick to Science: Look for resources backed by verified studies, like those we share at LifeBloom.

  • Join Trusted Communities: Engage with groups like our Bloomer Brigade, where women can share experiences and access credible information.

 
 
 

Finding the Right Support System

Menopause can feel isolating, but it doesn’t have to be. Surrounding yourself with a supportive community makes all the difference. At LifeBloom, we offer:
  • A thriving online community where women share their journeys and encourage one another.

  • Expert-led programs that provide the knowledge and tools to navigate menopause with confidence.

Your Next Step

Don’t let fear or misinformation hold you back. The science is clear: with the right tools, MHT and lifestyle changes can transform how you feel, look, and live after 65.

Ready to take control?

It’s time to thrive, not just survive. Let’s move forward—together.

A Personalized Menopause Journey

Every woman’s menopause experience is unique, and so are the solutions. The Baik et al. (2024) study, alongside other verified research, underscores the importance of tailored approaches to menopausal hormone therapy (MHT). Beyond the science, it’s about reclaiming your energy, confidence, and vitality in a way that works for you.

Imagine feeling like yourself again—sleeping soundly, thinking clearly, and embracing each day with renewed energy. Whether through low-dose transdermal estrogen, hormone-supportive nutrition, or a strength-building exercise routine, the tools are available to make this vision your reality.

At LifeBloom Menopause Institute, we’re here to guide you through this process with the expertise, resources, and community you need. Whether you’re navigating the challenges of perimenopause or looking to optimize your postmenopausal health, we’ll help you design a personalized game plan.

Let’s rewrite the story of menopause together. Visit LifeBloom Menopause Institute to learn more about how we can support you on your journey.

Conclusion

For decades, the conversation around menopause after 65 has been shrouded in fear and misinformation. But the latest research, including the Baik et al. (2024) study, offers hope and a new perspective. MHT, when personalized and combined with holistic lifestyle changes, can significantly reduce risks of mortality, cancer, cardiovascular disease, and cognitive decline.

The message is clear: menopause isn’t the end of vitality—it’s the start of a powerful new chapter. With the right tools and support, you can thrive like never before.

If you’re ready to take the next step:

The time to thrive is now. Let’s do this together.
 
 

References

  1. Baik, S. H., Baye, F., & McDonald, C. J. (2024). Use of menopausal hormone therapy beyond age 65 years and its effects on women’s health outcomes by types, routes, and doses. Menopause, 31(5), 363-371.

  2. Manson, J. E., Chlebowski, R. T., Stefanick, M. L., et al. (2013). Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA, 310(13), 1353-1368.

  3. Collaborators, M. H. T., & Beral, V. (2019). Type and timing of menopausal hormone therapy and breast cancer risk: Individual participant meta-analysis of the worldwide epidemiological evidence. The Lancet, 394(10204), 1159-1168.

  4. L’Hermite, M. (2017). Bioidentical menopausal hormone therapy: Registered hormones (non-oral estradiol + progesterone) the safest option. Climacteric, 20(5), 346-352.

  5. Hodis, H. N., Mack, W. J., Kono, N., et al. (2020). Hormone therapy and cardiovascular disease: The value of timing and delivery method. Circulation, 142(2), 139-150.

  6. Baber, R. J., Panay, N., Fenton, A. (2022). 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767-794.

The Bigger Picture on HRT

MHT is not a one-size-fits-all solution, but it can be a powerful tool for improving longevity, reducing disease risk, and enhancing quality of life when carefully personalized. Whether it’s through reducing mortality, protecting the heart and brain, or mitigating cancer risks, the potential of hormone therapy is undeniable when applied strategically.

At LifeBloom Menopause Institute, we take the latest research and combine it with practical strategies to help women thrive during menopause and beyond. Our approach includes tailored hormone therapy guidance, hormone-supportive nutrition, and functional fitness programs.

 

The science is clear, and the tools are here. Let’s redefine what thriving in menopause looks like—together.

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