When to Stop Hrt? How Old is Too Old?

[KatieP]

I was DIY for 30 years. At 59, I decided to "come clean" to all the doctors, start taking their actual advice, and all that. (Yeah, yeah. I know. Really...) Both GP and Endo were very supportive in every way. And, they both said, "No More E. There is too little information out there about the effects, but the risk of DVT over 60 is very high. And that is likely independent of sex." So, I stopped the estradiol and remained on Spiro about 11 months ago.

And, I don't feel like myself. I haven't felt "normal" for the last 6 months. It's very difficult to put my finger on the precise symptoms, by the big ones are insomnia, tired, and feeling blah/depressed.

I am going back to the Endo later this week for the quarterly appointment. I don't think I will beg, but I thought I would share anecdotal evidence from y'all about whether you continued HRT past 60, and if so, were there any adaptations, concerns, or problems?

Thanks for your insights!

K

[JudiBlueEyes]

I'm into my mid 60's and still on E via patches.  My doctor recommended this method due to age, DVT, and other medical concerns I have.  There are lots of us older women on E.   

[AnonyMs]

I asked my endo about this and he said as long as your body doesn't have any problems with hrt he just keeps it the same. He does blood tests to check health, things like liver function, etc. He dose really high estrogen blood levels too. Plus 3500 trans patients and decades of experience.

Personally I'm not stopping hrt unless I'm dying, and maybe not even then.

I'd get another doctor.

[Dani]

I am 68 and I take my E sublingual. I know the risks, but I feel the benefits outweigh the risks.

[Kendra]

If you are indefinitely on a T-blocker without any E, I'd be concerned about an increased risk of osteoporosis unless your test results somehow show the correct balance.  In fact it is bone density that pushed me into a faster transition - when I realized I had lost 4 inches (10cm) height between college and my 50's.  My body's endocrine system wasn't producing enough T or E, and I was told I would need to take one or the other (easy decision).  When I started HRT my endo ordered a bone density test to set a baseline.

Frankly if I was faced with your situation I would look for a different doctor. 

[Mendi]

No wonder you feel crappy. I get from your message, that your body still produces T (spiro?), so you don´t have any hormones in your body and to keep us going, this body needs hormones, be it T or E...though I guess you would feel crappy too, if the T would rise.

Get another doctor.

[Dena]

If a doctor refuses you all HRT without a medical reason, you should consider another doctor. I went that route and was off HRT for 10 years. I am now back on it but at about half a transition dosage. I was careful with my calcium intake so it appear my body didn't suffer but there were other effects. My body fat migrated to my belly and I lost it from my breasts, hips and the worst was from my face. My face looked gaunt and it aged my appearance. Your estradiol should at least test in the menopause range, preferably around 40-60 pg/ml. I am 66 and on pills without any harmful effects though I can understand it if the doctor wants you to use patches or some other delivery system.

[PurplePelican]

You're feeling like crap because you are hormone-deprived - you need adequate levels of either E or T to operate. I'd suggest to your doc they need to hit the books, as the crap they've spouted was what I got taught 20 years ago and I know things have changed since then..

At your age, I'd avoid oral meds. However, you should find gel or patches work fine and are fairly safe. IM injection is also an option, depending on location.

[Deborah]

I'm 58 and my Dr has me on a pretty high dose of oral E.  As long as you're healthy and taking care of yourself the risk is negligible.


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[KayXo]

Patches have shown to be safe in older populations and in populations at risk. A doctor must be abreast of the most recent studies to most effectively treat their patients. They may be thinking of oral conjugated equine estrogens, DES and/or ethinyl estradiol. Bio-identical estradiol is a whole other ball game!

Several studies have been published about the use of estrogen patches in men with prostate cancer who needed high estrogen to reduce testosterone to castrate levels. Despite high estrogen levels in these men, aged 49-91, and with cancer, there was no increased risk of DVT. A reduced risk was even noted.

Since the 1930's, estrogen pellets have been used in menopausal women, in some women, for the rest of their lives and, in general, such studies find no appreciable risk and several benefits despite quite high levels, up to 700-800 pg/ml.

[KatieP]

Thank you, thank you, all!

Seems like a unanimous vote...

K

[KathyLauren]

Make that unanimous + 1.

Heck, I started HRT past 60.  The clinic I go to only handles HRT for low-risk cases.  Anyone else gets sent to an endo.  They took me, put me on patches due to my age, and monitor my levels regularly.  Starting in June, I'll be on annual checkups instead of quarterly, since everything about me appears stable.

So there is nothing inherently risky about being over 60.  You'd have to have some other risk factor for it to be a problem.

[Barb99]

I started at 59 and was post op at 61. My doctor keeps my estrogen at 400-500 pg/ml. As long as my blood work keeps coming back normal I will stay at that level.

[Devlyn]

I don't want to take E  at a transition dose indefinitely. 16 year old emotions in a 60 year old body isn't a phenomenon I'm happy about. I  know some of the women here want to continue on that way. I suggest you reevaluate your wishes. 

Hugs, Devlyn

[Deborah]

My emotions didn't really change.  Maybe they were perpetually stuck at 16 since 1976.  On the emotional level HRT just eliminated all the bad stuff.  I would be concerned that stopping would let the bad stuff back in.


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[Charlie Nicki]

I don't want to take E  at a transition dose indefinitely. 16 year old emotions in a 60 year old body isn't a phenomenon I'm happy about. I  know some of the women here want to continue on that way. I suggest you reevaluate your wishes. 

Hugs, Devlyn

OMG lol! I'm super super emotional since starting HRT. I mean I always was but I'm way more now. I can cry so easily...It's good in a way because I can let it all out but other times I'm like, for F's sake grow a pair!!  (funny since I just had orchi).

And to @KatieP, I'm not over 60 but I've read so many stories of fellow transwomen here who are over 60 and on hormones that I also believe your doctor is giving you inaccurate or outdated information.

[PurplePelican]

I don't want to take E  at a transition dose indefinitely. 16 year old emotions in a 60 year old body isn't a phenomenon I'm happy about. I  know some of the women here want to continue on that way. I suggest you reevaluate your wishes. 

Hugs, Devlyn

That doesn't last forever. In fact, I'd be worried if it did.

[KayXo]

OMG lol! I'm super super emotional since starting HRT. I mean I always was but I'm way more now. I can cry so easily...

I tend to cry more and easily when my E is low. High levels keep me stable and good.

[KatieP]

I saw the endo today. Although she had seen previous labs, when I saw her last time, she ordered another set of labs. I presume, at this point, that she just wanted to make sure about the lab results before going back to Estradiol. And, she put me on patches, which was completely expected given the replies here.

As it turned out, I didn't even have to tell her all the stories from here. But I was ready, and I REALLY appreciate all your responses!!

Kate
PS. First time on patches. I really have to figure them out. Put on the first one, rolled up my panties, and the patch rolled right up with them. Geesh. Is this PEBPAB? (...Patch and Butt... :-) )

[sarah1972]

Just ask Laurie and Michelle [emoji23] they seem to enjoy their 16 year old emotions [emoji23]

Ask me and I can tell you 16 year old puberty raging teeny emotions in a 45 year old can get quite messy at times. So I get your point. But then... there is also a lot of fun in it. Got to go back to beer pong now.

I don't want to take E  at a transition dose indefinitely. 16 year old emotions in a 60 year old body isn't a phenomenon I'm happy about. I  know some of the women here want to continue on that way. I suggest you reevaluate your wishes. 

Hugs, Devlyn