I recently sat down with a patient named Martha, a vibrant 68-year-old grandmother who told me she felt like a shadow of her former self. “I’m active, I eat well, and I volunteer,” she said, “but my body feels like a house where the electricity is flickering out. My previous doctor told me I had to stop my hormones at 65 because of ‘the rules.’ Now, my joints ache, I can’t sleep, and I just feel … brittle.” What Martha didn’t know was that her doctor was following an outdated rule that medical experts have since abandoned.
The Rule That Wasn’t Really a Rule
For more than 20 years, the “65-and-out” rule for hormone replacement therapy (HRT) dominated American medicine. The practice emerged from a cautious interpretation of the 2002 Women’s Health Initiative (WHI) study, which initially highlighted risks that seemed to outweigh the benefits for older women. Doctors responded by reflexively pulling the plug on hormone support at 65, treating it as a hard cutoff.However, major medical organizations have now moved away from arbitrary stopping points. Both The Menopause Society and the American College of Obstetricians and Gynecologists now agree: If a woman is healthy and her quality of life is thriving on HRT, she can often continue indefinitely with annual check-ins.
