Who Should Not Use HT

The question of whether to take short-term hormone therapy (HT) is a personal one, best decided between you and your doctor, after you know the facts about the benefits and risks of hormone therapy. There are some women, however, who have certain risk factors that make them poor choices for hormone replacement.

You should not use HT or estrogen therapy (ET) if you have the following:

• Known or suspected pregnancy
• History of or high risk for breast cancer
• History of hormone-sensitive cancer
• Unexplained uterine bleeding
• History of blood-clotting disorders
• Liver disease
• Heart disease or a risk of heart disease

Cigarette smoking is not a contraindication or reason not to use HT or ET. However, smokers are urged to stop before treatment begins for general health reasons. For instance, cigarette smoking puts you at risk for developing coronary heart disease, which is something women are more vulnerable to developing after menopause.

Experts believe, based on scientific studies, that women with heart disease should not take hormones, nor should healthy women in general start taking hormones just to try to prevent heart trouble.

Doctors long believed that HT might provide preventive benefits for women against heart disease. However, research has suggested that while HT can improve certain heart disease risk factors (such as cholesterol levels), it may not provide a substantial cardiac benefit. In fact, women who have heart disease may have an increased risk of cardiac problems in their first year of using HT. However, women who begin HT within 10 years of menopause may have less risk of coronary heart disease due to HT than women farther from menopause.

External Sources The North American Menopause Society Menopause Guidebook: Helping Women Make Informed Healthcare Decisions Through Perimenopause and Beyond, (2001) The American Heart Association PEPI: Reducing Risk Factors for Heart Disease, The National Heart, Lung and Blood Institute The Women's Health Initiative, The National Heart, Lung and Blood Institute National Institutes of Health, US Department of Health and Human Services, National Heart, Lung and Blood Institute, NIH News. April 3, 2007.

This article was reviewed and updated June 2007.

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