what is the Australian Menopause guidelines on starting MHT after the age of 60yrs?

Australian guidance generally says starting MHT after age 60, or more than 10 years after menopause, is not usually recommended , but it can still be considered in selected women with persistent troublesome symptoms after an individualized risk–benefit review.

Practical meaning

• The usual “best window” is within 10 years of menopause or before age 60.

• After 60, the decision becomes more cautious because the balance of benefits and risks is less favorable for many women.

• Starting at that age is not automatically forbidden ; it depends on symptoms, cardiovascular risk, breast cancer risk, clot risk, and the presence of a uterus.

How it is typically approached

• Use the lowest effective dose and reassess regularly.

• Make sure there is a clear indication, such as significant hot flushes, night sweats, or other troublesome menopausal symptoms.

• If the goal is mainly vaginal or urinary symptoms, local vaginal estrogen is often preferred over systemic MHT, and it does not usually require a progestogen.

Australian menopause guidance in one line

Starting systemic MHT after 60 is generally discouraged, but a careful case- by-case decision can still support treatment for some women with ongoing symptoms.

What this means for a clinician discussion

A doctor would usually review:

• Time since final period.
• Personal and family history of breast cancer, VTE, stroke, and heart disease.
• Whether the uterus is intact, because that affects the need for progestogen.

• Whether non-hormonal options might work just as well.

Source-based takeaway

So the short answer is: Australian guidance does not recommend routinely starting MHT after 60, but it allows individualized exceptions when symptoms are significant and the risk profile is acceptable.

If you want, I can turn this into a concise forum-style reply or a clinician- style answer.