How Long Is Too Long On Hormone Therapy?
Q My mum is in her late 70s and has been on hormone therapy for menopausal symptoms since she was in her 50s. Is it harmful for her health to use MHT [menopausal hormone therapy] for such an extended period?
If your mum has used oestrogen continuously since around the onset of menopause, it’s probably safe for her to continue for as long as she still needs it. In fact, it’s probably keeping her heart and bones healthier than if she wasn’t on it. But the safest approach is to use MHT for the shortest duration needed to manage symptoms.
On average, women use MHT for around six years, but some women will continue to have significant symptoms for much longer. Your mum should consider a trial period off MHT every year or so to see if her symptoms return. If she still has symptoms, she should try restarting at a lower dose: the hormone dose required usually gets smaller as we get older.
If she still has her uterus, she should be on combined MHT which has both oestrogen and a progestogen to keep the lining of the uterus thin. In that case, she should see a doctor with expertise in menopause treatments to ensure that she is on the safest kind of progestogen for long term use. Some types can slightly increase your breast cancer risk after five years of use, but other types which do not have this effect are available.
This answer is very general of course, and doesn’t take into account any other medical conditions she might have. MHT can have negative outcomes for some women – we wouldn’t use MHT in a woman who has had breast cancer, for example. Some types can also increase your risk of unwanted blood clots. The bottom line, as always, is to have an individual assessment by a doctor who’s experienced in menopausal medicine.
Answer provided by Dr Kelly Teagle, founder and principal of the WellFemme Telehealth Menopause Clinic. Kelly sees patients via Telehealth and in person at her Canberra practice.