Hormone Replacement Therapy: Risks and Precautions

Considering hormone replacement therapy? Here are some things to think about.

The FDA recommends that certain women do not use hormone replacement therapy:

  • Women who might be pregnant
  • Women with a personal history of breast or ovarian cancer
  • Women with a personal history of certain forms of endometrial cancer
  • Women with a personal history of pulmonary embolism, deep vein thrombosis, heart attack, or stroke
  • Women who have active liver disease. (Though women with liver disease may be able to use hormone replacement therapy in patch form.)

If you fall into those categories, talk to your doctors about alternative, non-hormonal treatments for menopause symptoms.

If you are a candidate for hormone replacement therapy, it’s time to weigh the risks against the potential benefits.

Hormone replacement therapy can raise the risk of several serious health problems. In a small number of women, hormone replacement therapy can cause some serious issues. Studies have shown that using hormone replacement therapy can:

  • Increase your risk of breast cancer.
  • Lead to larger/more advanced breast tumors as compared to women with breast cancer who did not use hormone replacement therapy.
  • Increase the risk of stroke in all healthy postmenopausal women — regardless of risk factors.
  • Increase the risk of heart disease slightly for women who are ten or more years past menopause.
  • Increase the risk of blood clots in the lungs (pulmonary embolism) and legs (deep vein thrombosis) in all healthy postmenopausal women — regardless of risk factors.
  • Raise the risk of Alzheimer’s disease and other forms of dementia for women aged sixty-five and older.
  • Increases the risk of ovarian cancer slightly.
  • Increases the number of abnormal mammograms that require additional evaluation by medical professionals — combination estrogen and progestin therapy can increase breast density.

Experts aren’t sure yet whether or not using low-dose therapy and short term therapy can eliminate these risks.

One note for women using a patch form of hormone replacement therapy: direct sunlight or high heat can increase the amount of hormone released from a patch, giving you a big dose at once, and leaving less hormone for release later in the week. Avoid direct sunlight, using a tanning bed, hitting the hot tub or sauna, or using an electric blanket while using a hormone patch.