7 Comments

Thanks for this. This is such a frequent QoL issue that comes up in my office.

Expand full comment

Thank you, Dr. Jen!!!

Expand full comment

Hi. You said, “Starting hormones earlier than 60 or within 10 years of menopause is neutral for cardiovascular disease and dementia.” Does this mean you don’t need to stop taking estrogen once you’ve reached your 60’s? Thank you for all you do to educate about women’s health issues!! Especially important now. 💚

Expand full comment

In general we don't think people need to stop, it's a new start that is the concern. However, people should be evaluated once a year to make sure cardiac risk factors haven't changed.

Expand full comment

What about if you went on and off hormones during your 50s? I'm off now and am 60. Still having hot flashes, brain fog, difficulty sleeping, and joint pain. My last period was about 7 years ago.

Thank you so much for all this information. You're like a light in the dark.

Expand full comment

Hi Dr. Jen! Thank you for all the evidence-based information you share! It is much appreciated. Can you expand more on the evidence about starting transdermal MHT after the age of 60 or >10 year after menopause? I am familiar with the results of the WHI and risks of oral MHT in these age groups. Curious about your thoughts on transdermal estrogen for these groups?

Especially for a person in their early 60s who has severe osteoporosis (and is already taking bisphosphonates but wants to further lower her risk of fractures/disease progression). No other CVD or dementia risk factors. It seems for a person like this, the benefits may outweigh the risks for low-dose estrogen patch, but I struggle to find evidence to say so definitively.

Would love to hear what your approach would be for the person/patients like her!

Expand full comment

I was using an E-String but it is not covered by KP insurance and is insanely expensive. I switched to Yuvafem and I don't think it is really helping. I read your blog post on your website about the ineffectiveness of low dose estrogen. I would really like help with understanding options.

Also, my doctor prescribed a progesterone gel that was mixed in the pharmacy. I saw your Tik Tok about how there is not enough control in how much you are actually getting with these type of products. Can you comment on that?

Thank you!

Expand full comment