30 Years on Hormone Replacement
Question
I am 72 yrs old, have had a partial hysterectomy back when I was 42 and have continued to take HRT. The last five yrs. I have gone to Biest only once a day for five days. Is it important to continue this therapy for the rest of my life?
Thank you,
Roz
Answer
Last Updated: April 12, 2025
Why are you on biest? You always need to evaluate the rationale for continuing a medication on a yearly basis. Circumstances can change, and you need to weigh the benefits and risks in your individual situation. Hormones should be used in the lowest doses that achieve the objectives you are using them for, and for only as long as necessary to achieve your goals. The benefits of estrogen include better sleep and improving mood for many women. There may be some advantages in preventing heart disease and cognitive function, although most improvement occurs in early menopause. If you have osteoporosis or osteopenia, estrogen may be stabilizing your bone density, and that could be a reason to continue therapy. For most women vasomotor symptoms—hot flashes and night sweats—do not go on indefinitely, although there are certain women who have intractable vasomotor symptoms for years. However, at age 72 most women should have weaned off estrogen, with the possible exception of vaginal estrogen for vaginal symptoms. If you have osteopenia or osteoporosis and/or feel terrible without estrogen, that might justify continuing estrogen. The downside of continuing biest is that your chances of getting breast cancer and stroke are slightly increased. At 72, consider a trial of stopping your hormones, and you may find you do well without them. Mary L. Davenport, M.D.
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