Short answer
There is no fixed time limit. The Menopause Society's 2022 position statement says hormone therapy does not need to be routinely stopped at 60 or 65, and that longer use should be for a documented reason with periodic reevaluation. In November 2025 the FDA asked makers to drop the "shortest amount of time" line from the boxed warning.
What the Menopause Society says
The 2022 Hormone Therapy Position Statement of The North American Menopause Society, now The Menopause Society, is direct: there is no general rule for stopping systemic hormone therapy at age 65, and it does not need to be routinely discontinued in women older than 60 or 65.
It adds conditions. Longer durations should be for documented reasons such as persistent hot flashes, with shared decision-making and periodic reevaluation. Extended use beyond 65 should include a regular review of your other health conditions, and the statement says to consider periodic trials of lowering or stopping the dose.
Why 60 and 10 years keep coming up
Those numbers are mostly about when you start, not when you stop. The statement says the benefit-risk ratio is favorable for women younger than 60, or within 10 years of menopause onset, who have no contraindications.
For women who start more than 10 years after menopause or after 60, it appears less favorable because of greater absolute risks of coronary heart disease, stroke, blood clots in veins and dementia. The statement is also honest about a gap: evidence on safety, risks and benefits of continued use in healthy women older than 65 is insufficient.
What the FDA changed
For two decades, labels carried a boxed warning that included advice to use the lowest effective dose for the shortest amount of time. On 10 November 2025 the FDA asked manufacturers to remove that recommendation from the boxed warning, along with the language on cardiovascular disease, breast cancer and probable dementia.
The FDA did not set a new time limit in its place. Warnings about cardiovascular disease and breast cancer stay elsewhere in the label. Labels are being updated product by product, so your package insert may still show the older wording.
What a yearly review covers
ACOG's patient guidance says you and your ob-gyn should talk every year about whether to continue, based on your symptoms, risks and benefits, and that some women may need longer therapy if symptoms go on for a long time.
The Menopause Society notes that hot flashes return in about 50% of women when hormone therapy is stopped, and that there is no consensus on whether stopping abruptly or tapering is better. How long you stay on it is a decision to make with your prescriber, and to revisit.
Related questions
Do you have to stop hormone therapy at 65?
No rule requires it. The Menopause Society's 2022 statement says routine discontinuation at 65 is not supported by evidence, and that continuing past 65 is a reasonable option for otherwise healthy women with persistent hot flashes, with counseling and regular reassessment.
Is vaginal estrogen treated differently?
Yes. The 2022 statement says low-dose vaginal estrogen for genitourinary symptoms may be considered at any age and for extended duration, if needed.
Does bone protection last after you stop?
Not for long. The 2022 statement says bone density falls back to pretreatment levels within 1 to 2 years of stopping therapy.
Read next
Sources
- The Menopause Society: The 2022 Hormone Therapy Position Statement of The North American Menopause Society (2022)
- FDA: FDA Requests Labeling Changes Related to Safety Information for Menopausal Hormone Therapies (10 Nov 2025, current as of 12 Feb 2026)
- ACOG: Hormone Therapy for Menopause, FAQ517 (last reviewed February 2024)
Published 2026-10-04 · Last checked 2026-10-04
Educational content, not medical advice. Made for the United States.