Q: I’m 80 years old … can I take estrogen hormones so that I can have intercourse with my partner?

Ask the Doctor

Isaac Schiff, MD

The average age of menopause in the US is 51. Generally speaking, hormone therapy (HT) is usually started at or near the age of menopause when women are symptomatic. The goal is to use HT in the lowest dosage necessary to relieve menopausal symptoms for the shortest amount of time possible. The 2002 Women’s Health Initiative study found that postmenopausal women who took HT had an increased risk of heart attacks, stroke, and venous thromboembolic disease in the first few years of use. Today, the general consensus is that starting hormones many years after menopause is not wise.

Older women, especially those becoming sexually active after a long period of abstinence, may consider first trying lubricants to help ease discomfort during intercourse. Although many older women experience vaginal atrophy and dryness due to hormone loss, there are nonprescription ways to ease back into having intercourse after a long hiatus. The key is to take it slow until the vagina adjusts to intercourse.

Many elderly women are involved with men who take erectile dysfunction medication. These medications cause erections that are more rigid and longer-lasting than would normally be the case. This can add to the discomfort for a woman who has not had intercourse for a long time.

If nonhormonal methods don’t work, your doctor can talk with you about using a low-dose HT that is applied directly into the vagina such as a ring, cream, or pill. This type of HT helps restore elasticity and improve blood flow to the vagina. Its effects are predominantly limited to the vagina, and it is thought that since only a small amount of the hormones get into the bloodstream, theoretically the risks of taking it should be minimal.