Can women still benefit from menopausal hormone therapy (HRT) after the age of 60, or has the opportunity passed? For many years, women were advised that menopausal hormone therapy was best started close to the onset of menopause. However, since the FDA’s black-box warning lift, evolving research and a more personalised approach to care have prompted many women to revisit the conversation later in life. To explore what current evidence tells us, Paola Chellew spoke to Dr Sibu Lubelwana, Obstetrician & Gynaecologist, and Dr Simone Silver, Functional Doctor at Hormonal Health & Wellness Centre, about starting HRT after 60, balancing benefits with risks, and why treatment decisions should always be individualised.
For many years, hormone replacement therapy (HRT), now more commonly referred to as menopausal hormone therapy (MHT), has been associated with the start of menopause in order to ease symptoms like hot flushes, sleep disruption and mood changes. Along with the relief came certain health risks, which made the option of taking hormones bittersweet. But in 2025, the FDA removed the black-box warnings, conveying the message that the benefits of HRT far outweigh the risks.
These changing attitudes, together with improved research and a better understanding of the benefits and risks, have prompted many women in their 60s – and even beyond – to ask an important question: Have I missed the window?
I asked two medical experts, Dr Sibu Lubelwana (Obstetrician & Gynaecologist) and Dr Simone Silver (Functional Doctor at Hormonal Health & Wellness Centre), to give insights into whether starting HRT later in life is a possibility, as well as how doctors address risk versus reward.