In theory, people can take HRT for the rest of their lives, but the risks involved may increase with age. Doctors advise taking an individualized approach and regularly weighing the benefits and risks.

Sometimes referred to as menopausal hormone therapy, HRT can provide long-term relief from menopause symptoms and may also have additional benefits for people under 60 years who are within 10 years of menopause and have no other contraindications.

This article explains whether it is safe to take HRT for extended periods and discusses the benefits and risks associated with long-term use.

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According to the National Health Service (NHS) in the United Kingdom, there is no definitive limit on how long people can take HRT. However, it is important to talk with a doctor before starting or extending usage.

In 2017, the North American Menopause Society updated its guidance, which was to take the lowest dose of HRT for the shortest duration necessary to address menopause symptoms. After reviewing the literature, they concluded that this advice may be “inadequate or even harmful for some women.”

The updated guidance suggests taking the appropriate dose, duration, regimen, and route of administration that is most beneficial with the least risk.

People over 65 can continue using HRT for hot flashes, osteoporosis prevention, and quality of life issues. However, they must understand the benefits and risks of taking HRT long-term.

Learn more about the types, uses, and effects of HRT.

The NHS indicates that the benefits of HRT usually outweigh the risks.

According to a 2020 data-based study, long-term use of HRT may prevent bone fractures and lower the risk of bowel cancer.

Other potential benefits of long-term HRT use include:

Can long-term HRT use improve other health conditions?

Depending on the dose and duration, HRT may reduce a person’s risk of developing certain chronic conditions.

These include:

HRT is not a cure for these conditions, but it may help reduce the risk or delay the onset of these health conditions in some people.

While long-term HRT use may have benefits, it is important to consider the potential risks, such as an increased risk of breast cancer.

For example, if a person takes a combination of estrogen and progestin for longer than 5 years, the risk of breast cancer may increase even after they stop HRT.

Other potential risks of long-term HRT use include:

Learn more about whether HRT can cause breast cancer.

Whether or not people should reduce their dose of HRT as they age depends on individual factors and ongoing conversations with a doctor.

Doctors may advise people over 50 to gradually reduce their dose of HRT over time, as the body’s hormone needs naturally decrease with age.

Some healthcare professionals recommend having a break in HRT every 2–3 years to assess whether they still need it. This is also an opportunity to evaluate the potential risks and benefits in light of a person’s evolving health status.

Learn ten essential facts about menopause.

Below are answers to some frequently asked questions about taking HRT long term.

Do menopause symptoms come back after stopping HRT?

Most people who take HRT stop taking it after their menopausal symptoms subside. This is typically 2–5 years after starting HRT, but it can be longer for some people.

If a person’s menopausal symptoms return after stopping HRT, they will typically go away within a few months.

Is it safe to take HRT for 20 years?

The safety of taking HRT for 20 years depends on several factors, including the type of HRT, the dose, and the individual’s risk factors.

There is some evidence that long-term use of HRT may increase the risk of certain health conditions, such as breast cancer, endometrial cancer, and blood clots.

However, other studies have shown that HRT can be safe and effective for long-term use, especially when a person starts using it at a younger age and at the lowest effective dose.

At what age do you no longer need HRT?

Some people aged 60 years or older or more than 10 years postmenopausal may be at greater risk of developing certain conditions. Therefore, the decision to continue or discontinue HRT should depend on individual factors, such as symptoms, overall health, and discussions with a doctor.

HRT can help relieve the symptoms of menopause, such as hot flashes, night sweats, vaginal dryness, and mood swings.

HRT may also help prevent certain chronic health conditions, though scientists need to carry out more research to understand its preventive effects.

HRT is generally safe and effective for long-term use, especially when started at a younger age and taken at the lowest effective dose. However, talking with a healthcare professional about the risks and benefits of HRT before starting treatment is important.

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