The North American Menopause Society Statement on Continuing Use of Systemic Hormone Therapy After Age 65

The 2012 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) states that hormone therapy (HT) is the most effective treatment for symptoms of menopause.1 To maximize safety, the initiation of HT should be considered for healthy symptomatic women who are within 10 years of menopause or aged younger than 60 years and who do not have contraindications to use of HT. Contraindications are well established and should be considered in making this decision. However, vasomotor symptoms persist for an average of 7.4 years and for more than a decade in many women.2 Moderate to severe vasomotor symptoms have been documented in 42% of women aged 60 to 65 years.3 Thus, many women will continue to have vasomotor symptoms after age 65, and these symptoms can disrupt sleep and adversely affect health and quality of life.2-4

Provided that the woman has been advised of the increase in risks associated with continuing HT beyond age 60 and has clinical supervision, extending HT use with the lowest effective dose is acceptable under some circumstances, such as for the woman who has persistent bothersome menopausal symptoms and for whom her clinician has determined that the benefits of menopause symptom relief outweigh the risks. Use of HT should be individualized and not discontinued solely based on a woman’s age.5 The decision to continue or discontinue HT should be made jointly by the woman and her healthcare provider.