Is it too late to start HRT after 60?

Author

Wellbeing Team

1 November, 2026
Is it too late to start HRT after 60?

Liz is regularly asked what age is too late to consider HRT and explores the benefits and risks of starting after 60. She explains how body identical patches and gels have moved on from older tablet forms of HRT and talks about how vaginal oestrogen can offer relief from dryness, discomfort and UTIs.

Plus: advice for dating in later life, exercising safely after injury, ways to treat sebaceous filaments and what to do if you’re struggling to lose weight after 50.

Stream the episode below, or download the recording via Apple Podcasts or Spotify.

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Have I missed my chance to consider HRT?

Many women worry they’ve left it too late to benefit from hormone replacement therapy (HRT) once they reach 60. And while starting HRT later in life requires a careful, individual assessment, it’s just a case of exploring your options with the right medical support.

Your symptoms, general health and how long it has been since your menopause will all influence the decision, but as Liz explains, there’s still a chance to experience the benefits HRT can bring.

When is the best time to start HRT?

“The most favourable time to start for most women is before 60 and within around 10 years of their last period,” she says. Starting later may mean missing out on some longer-term benefits, like the protection oestrogen provides against bone loss while you’re taking it.

But as Liz points out, even starting after 60 means you may still experience relief from the hot flushes, insomnia, low mood, dry skin, dry eyes and vaginal dryness that often come post-menopause.

Why the type of HRT matters

The formulation and how it’s delivered are important considerations. Liz explains that older synthetic tablet forms of HRT have a different risk profile from modern transdermal oestrogen, which is delivered through the skin via patches, gels or sprays.

Oestrogen taken as a tablet passes through the liver and affects clotting factors, whereas transdermal oestrogen avoids this. It’s a distinction worth discussing with your GP, particularly if you’ve been told in the past that HRT may not be suitable for you.

Don’t overlook vaginal oestrogen

Systemic HRT isn’t the only option. Liz highlights vaginal oestrogen as a treatment worth exploring if you’ve struggled with vaginal dryness, soreness or discomfort post-menopause. It acts locally as a gel, cream or pessary and can be helpful for reducing recurrent urinary tract infections.

Get personalised advice

HRT is never a one-size-fits-all decision, particularly when starting after 60. It’s important to go through various options with your GP or a healthcare professional experienced in menopause care. Liz recommends downloading the free hormone health app Balance, which has a lot of helpful information on how to approach your GP.

If you’ve been without hormones for many years, starting systemic HRT can bring side effects such as intermittent bleeding or breast swelling and tenderness. “You’re reintroducing hormones that you had when you were younger and your body has to adjust,” explains Liz. Your GP may recommend starting at a lower dose and adjusting it according to how your body responds.

Above all, starting HRT later in life doesn’t mean you’ve missed your opportunity. It just means doing your research and having an informed discussion about your symptoms, individual risks and the potential benefits.

Age Better with Liz Earle is not medical advice. If you need help with a health concern, please speak to a doctor. 

Also in this episode:

  • The realities of dating after 50
  • Dating websites versus apps
  • Should I exercise with a pelvic floor condition?
  • Why you might be struggling to lose weight
  • Tips for maintaining a healthy weight in midlife
  • When is the best time to start HRT?
  • Is it blackheads or something else?

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