Aging Well After 65: Reopening the Hormone Conversation

When the Question Isn’t “Should We?” but “What Does This Body Need?”

Dr. Tracy Tranchitella, ND | Sunrise Functional Medicine

For years, many women have been given a quiet but firm message about hormone therapy: there’s a cutoff. Somewhere around age 60 or 65, the conversation is expected to end. Symptoms that persist beyond that point—fatigue, sleep disruption, brain fog, anxiety, joint pain, loss of strength—are often attributed to “just getting older.” But functional medicine asks a different question.

Instead of “Is hormone therapy still allowed at this age?” the more meaningful question becomes:
What does this individual body need to stay resilient, strong, and well? At Sunrise Functional Medicine, Dr. Tracy Tranchitella, ND approaches hormone care through that lens—one that prioritizes physiology, quality of life, and thoughtful, personalized decision-making over age-based rules.

Age Isn’t the Same as Biology

Chronological age tells us how many birthdays someone has celebrated. It doesn’t tell us how their nervous system is functioning, how resilient their metabolism is, how strong their bones are, or how well their brain is supported.

Two women can be the same age and have completely different health profiles. One may be active, sleeping well, cognitively sharp, and physically strong. Another may be struggling with fatigue, mood changes, muscle loss, and disrupted sleep—yet both are often told that these changes are simply part of aging. Functional medicine resists one-size-fits-all assumptions. It looks at patterns, not just numbers. And it recognizes that hormones continue to play a meaningful role in the body well beyond the menopausal transition.

Hormones and Healthy Aging: The Bigger Picture

Hormones are often discussed narrowly—hot flashes, night sweats, mood swings—but their influence is far broader, especially as we age.

Muscle mass and strength
Loss of muscle is one of the biggest predictors of frailty and loss of independence later in life. Estrogen, progesterone, and testosterone all influence muscle maintenance, recovery, and physical strength. When hormones decline, maintaining muscle becomes more difficult—even with regular exercise.

Bone health beyond the DEXA scan
Bone density matters, but so does balance, coordination, and muscle strength. Hormones play a role in bone remodeling and fracture risk, and they don’t operate in isolation from vitamin D levels, inflammation, gut absorption, or overall metabolic health.

Brain health and cognitive resilience
Estrogen, in particular, supports blood flow to the brain, neurotransmitter balance, and neural protection. Many women notice changes in memory, focus, or mental sharpness as hormones decline—changes that are often brushed off rather than explored.

Sleep and nervous system regulation
Hormonal shifts can significantly affect sleep quality and stress tolerance. Poor sleep isn’t just an inconvenience; it impacts immune function, mood, cardiovascular health, and cognition.

Metabolism and energy
As hormones change, so does the body’s ability to regulate blood sugar, maintain energy, and respond to stress. Fatigue and weight changes are often treated as isolated issues, rather than signs of a shifting hormonal landscape.

When these systems are viewed together, it becomes clear that hormones aren’t about preserving youth—they’re about supporting function.

What Happens When the Conversation Stops Too Soon

One of the quiet challenges many women face after 65 is not being told that hormone therapy is unsafe—but being told that it’s no longer worth discussing. Symptoms get normalized. Fatigue becomes expected. Sleep disruption is brushed aside. Anxiety, low mood, and brain fog are framed as personality changes or inevitable decline. Many women stop asking questions, assuming nothing can be done.

Functional medicine takes a different approach. Rather than closing the chart, it keeps asking:

• What changed?
• When did symptoms begin?
• What systems might be under strain?
• What support could restore balance?

Sometimes hormones are part of that picture. Sometimes they aren’t. But the conversation itself remains open.

A Functional Medicine Approach to Hormones After 65

At Sunrise Functional Medicine, hormone therapy is never a default—and it’s never ruled out based on age alone. Dr. Tracy Tranchitella, ND evaluates hormone support within the context of the whole person, including:

• Health history and symptom patterns
• Cardiovascular risk and inflammatory markers
• Gut health and nutrient absorption
• Stress response and sleep quality
• Personal goals for health, energy, and independence

Laboratory testing is used as a guide, not a verdict. The goal is not to chase numbers, but to understand how systems are interacting—and where thoughtful support may improve quality of life. Importantly, hormone therapy is not “all or nothing.” For some women, low-dose or targeted support may be appropriate. For others, addressing lifestyle factors, inflammation, or metabolic health may offer more benefit. Functional medicine allows for nuance.

Reframing the Conversation About Aging

Aging well doesn’t mean ignoring symptoms or accepting discomfort as the price of getting older. It means staying engaged with your health, asking better questions, and working with a provider who sees aging as a dynamic process—not a decline with an expiration date.

Hormone therapy after 65 isn’t about turning back the clock. It’s about supporting strength, clarity, resilience, and quality of life—when appropriate, and always on an individual basis. The most important takeaway? No one should age out of thoughtful, personalized care. 

For women navigating this stage of life, a functional medicine approach offers something invaluable: permission to keep the conversation going.  Learn more and request a consultation >>