MON-202 Hormone Replacement Therapy Initiation Beyond the Ten Year Window Protocol

Abstract Disclosure: H. Hodis: None. C. Dominguez-Bali: None. E.S. Johnson: None. H.A. Goraya: None. M.A. Syed: None. W.K. Massah: None. K. McCoy: None. M.A. Bencomo: None. E.S. Tsehaye: None. R. Polam: None. A. Dominguez-Bali: None. In our 2 medical centers, more than 50% of postmenopausal (PMP) women seeking care for their symptoms exceed the typical 10 year window protocol for the initiation of Hormonal Replacement Therapy (HRT) under current guidelines. To address this gap, we develop the protocol to treat a significant subset of these affected women with HRT beyond the 10 years window protocol. The purpose of this study is the evaluation of the utilization and safety of late HRT in symptomatic or asymptomatic PMP women using coronary calcium score (CCS). This retrospective analysis examines clinical outcomes for more than 100 patients (108) over the past 8 years. Women with a CCS of zero were eligible for full systemic HRT. With close follow up, considering individual comorbidities, preferences and responses, women with CCS above 50 were given local treatments, vaginal estradiol and testosterone without systemic HRT (vaginal estradiol and levonorgestrel transdermal patch) and patient outcomes were assessed using standardized questionnaires documenting symptom relief, hormone response, personal satisfaction and quality of life. Preliminary findings suggests that woman with a CCS of 0 experience symptom relief and therapeutic responses comparable to those initiating HRT within the recommended 10 year window protocol. Up to now, we have confirmed that CCS provides flexible treatment options. This study indicates that a significant number of late PMP women that go under the 10 year window protocol or are more than 60 years of age with a CCS of 0 can benefit from the delayed HRT achieving outcomes similar to early initiators of HRT. More studies need to be done that confirm that offering HRT in late menopause could be as secured and beneficial as those initiated in early menopause. Presentation: Monday, July 14, 2025