Study shows hormone therapy offers lasting benefits for women over 65

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In a new retrospective analysis, results demonstrated that hormone therapy (HT) can still be beneficial for women well beyond the age of 65.

According to the latest position statement from The Menopause Society in 2022, women older than 65 years can continue HT, provided they receive appropriate counseling and risk assessments. The findings of this analysis were presented at the 2024 Annual Meeting of The Menopause Society in Chicago, scheduled for September 10-14.

Menopause is a life phase that can significantly impact a woman’s quality of life. It is estimated that 70% to 80% of women experience symptoms of menopause, with many finding these symptoms detrimental to their daily productivity.

Hormone therapy has long been regarded as the most effective way to manage many of the challenging symptoms, particularly hot flashes. For the average woman, the duration of hot flashes can last between 7 and 11 years, but a substantial number of women continue to have symptoms well into their later years. Research indicates that 40% of women in their 60s and 10% to 15% of those in their 70s still suffer from hot flashes.

The recent analysis focused on over 100 women aged 65 and older who are still actively using HT. The goal of the study was to better understand the characteristics of these women, their motivations for continuing the therapy, and the benefits they experience.

The mean age of participants was 71 years, with 8% of women aged 80 or older. On average, these women began HT around the age of 52, just 2 years after the typical age for menopause onset. Most had been using HT for an average of 18 years, with 42% having been consistent users for more than 2 decades.

The most common reason for continuing HT beyond the age of 65 was the management of hot flashes, cited by 55% of participants. Other reasons included improving overall quality of life (29%) and alleviating chronic pain and arthritis symptoms (7%). Also, more than a quarter of the women in the study had attempted to stop HT at least once, but 87% of these women chose to resume treatment because their hot flashes returned.

The analysis also revealed a preference for transdermal forms of estrogen, which were used by 88% of participants, compared to only 12% who used oral estrogen pills. Synthetic progestins were used by fewer than 5% of the women. Despite some documented adverse effects, such as postmenopausal bleeding, the analysis found no evidence of more serious complications like strokes, heart attacks, or uterine cancer.

"Many women aged beyond 65 years have validated menopause symptoms that severely affect their quality of life, and that's why they rely on hormone therapy," says Meenakshi Goel, MD, the lead author of the study, which was supervised by Wendy Wolfman, MD, FRCS(C), FACOG, NMCP, director of the Menopause and Premature Ovarian Insufficiency Clinic at Mount Sinai Hospital in Toronto, Ontario. Goel highlights the importance of health care professionals being open to the continued use of HT in older women, providing appropriate counseling, and regular evaluations for potential risks are in place.

Stephanie Faubion, MD, MBA, the medical director of The Menopause Society, adds that extending hormone therapy may not be suitable for every woman. "Extending hormone therapy use might not be the best option for all women," she says. "However, for most women, it's not necessary to discontinue hormone therapy simply because they've reached a predetermined age. Consideration must be given to their specific risk factors and health status."

These findings highlight the importance of individualizing care and offering older women more flexibility when it comes to managing menopause symptoms with HT, ensuring that their treatment is both safe and effective.

Reference:

Goel M, Ly K, Wolfman W. Retrospective analysis of the use of menopausal hormone therapy in women more than 65 years of age: First Canadian experience. Presented at the 2024 Annual Meeting of The Menopause Society. Chicago, Illinois. September 10-14, 2024.