Is It Ever Too Late for HRT? Timing, Tests and What to Ask Your Doctor
Originally published on YouTube on 3 September 2026.
Original video: https://www.youtube.com/watch?v=oCSbRP03j3U
Your birthday doesn’t decide whether you start or stop hormones. Your arteries, bones, and health numbers do.
This is Part 2 of my Q&A with Steve Goldring, RPh, a licensed pharmacist with 30+ years of experience compounding menopause hormones and training clinicians who prescribe them.
Part 1 covered menopause, the 2002 WHI study, what’s changed, and hormone options, doses, and forms.
Watch Part 1 first: https://apoe4.link/TherapyY
I am Dr. Kevin Tran, Doctor of Pharmacy. I carry APOE4/4, and I built The Phoenix Community because I needed it first.
Get the free APOE4 Woman's Guide: https://thephoenix.community/guides/womens-guide
PHOENIX
Build your personal protocol, track progress and learn with carriers like you.
Apply to join Phoenix: https://apoe4.link/SteveQnA2
MORE RESOURCES
Essential APOE4 Guide: https://apoe4.link/SteveQnA2G
Weekly Newsletter: https://apoe4.link/SteveQnA2N
STEVE'S LINKS
YouTube: @SimpleHormones
Instagram: @thehormonepharmacist
His program, Seven Steps to Clarity and Confidence About Hormones: The Menopause Solution: https://www.simplehormones.com/
WHAT WE COVER
00:00 Teaser
00:20 Podcast introduction
03:46 Recap: What Part 1 covered
05:26 Is it too late? Five community questions on starting HRT late
06:49 Why women's heart risk catches up to men's by 60
09:22 How plaque builds up, and the tests that show it
11:38 How to measure plaque: CAC scan vs. CIMT test
14:38 Transdermal vs. oral estradiol and blood clot risk
16:04 Best time to start HRT
18:47 Starting Hormones 10 Years After Menopause
20:53 Do Hormone Benefits Change If You Start Late?
22:58 Which Menopause Symptoms Get Better or Worse?
24:04 Hysterectomy and Early Menopause
26:26 Should You Stop Hormones at 60 or 65?
29:50 High cardiovascular risk? What's still on the table
32:44 How to Stop Being Dismissed by Your Doctor
34:57 Steve's HRT Questions Framework, and the cheat sheet that builds trust fast
38:40 Finding a Doctor Who Understands Hormones
41:38 Being more directive with your doctor when you're already informed
49:30 The Big Five hormones, and his estradiol target
54:23 Recommended blood tests & target levels (estradiol/progesterone) + APOE4-specific thyroid (T3/Free T3) note
01:00:39 What to test if you carry APOE4, and blood vs. saliva vs. urine
01:06:16 SHBG (sex hormone binding globulin) deep dive
01:10:16 Dosing to relieve symptoms vs. dosing to optimal blood levels
01:12:11 Vaginal estrogen vs. systemic estrogen risk
01:14:03 Compounding pharmacies vs. Big Pharma, Bi-Est and cream bases
01:19:17 A bad compounded batch: QA and how to vet a compounding pharmacy
01:23:28 Natural vs. chemical framing
01:25:16 Where to find Steve, and Kevin's closing line
01:28:26 Outro