“Although cigarette smoking does not prohibit hormone therapy use, smokers are urged to stop smoking before beginning ET or EPT”.1

Umbrella
What may the Hormone Therapy and Smoking Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Estrogen Therapy (ET)
  • Estrogen-Progestogen Therapy (EPT)
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Therapy (MHT)
  • Smoking

Quit SmokingHormone Therapy and Smoking

What are smokers who choose to use hormone therapy (HT) urged to do?

The North American Menopause Society (NAMS) explain:

“Although cigarette smoking does not prohibit hormone therapy use, smokers are urged to stop smoking before beginning ET or EPT”.2

What is ET?

In the NAMS’s Hormone Help Desk: ET, EPT, and More: Estrogen Therapy (ET), ET is an abbreviation for Estrogen Therapy.

What is EPT?

In the NAMS’s Hormone Help Desk: ET, EPT, and More: Estrogen-Progestogen Therapy (EPT), EPT is an abbreviation for Estrogen-Progestogen Therapy.

Hormone Therapy Options

What are HT options?

In Ask the Nurse: A 54 year old lady who has smoked for 25 years is on estradiol and progesterone for menopause. Can she take oral estradiol, or is estradiol patch a better choice? Also, is there any contradiction for HT for smokers? the (United States) Speaking of Women’s Health Nurse explains:

A. …“Hormone therapy in smokers can be given transdermally or orally. Transdermal is more recommended if the patient has a history of DVT or high Triglycerides, GI issues or high blood pressure. If she has a uterus, both estrogen AND progesterone/progestin are needed with hormone therapy.

There are many menopausal treatment options. Sometimes smokers metabolize estrogen faster and may not be able to use ultra low doses of estrogen if they have marked hot flashes”.3

Health Care Provider

If I am a smoker and choose to use HT, what are my risks?

If you are a smoker and choose to use HT, it may be in your best interest to also choose to talk to your health care provider about this.

One of the points of consensus about menopausal hormone therapy (MHT) in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, is:

  • “The option of MHT is an individual decision in terms of quality of life and health priorities as well as personal risk factors such as age, time since menopause and the risk of VTE, stroke, ischemic heart disease and breast cancer. MHT should not be recommended without a clear indication for its use”.4

What is VTE?

VTE can be an abbreviation for Venous Thromboembolism.

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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. North American Menopause Society. Menopause Guidebook: 4 Do I Need Treatment? Weighing the Benefits and Risks of Hormone Therapy: Who Should Not Use Hormone Therapy? Smokers, 8th Edition, 2015:28
  2. North American Menopause Society. Menopause Guidebook: 4 Do I Need Treatment? Weighing the Benefits and Risks of Hormone Therapy: Who Should Not Use Hormone Therapy? Smokers, 8th Edition, 2015:28
  3. Ask the Nurse: A 54 year old lady who has smoked for 25 years is on estradiol and progesterone for menopause. Can she take oral estradiol, or is estradiol patch a better choice? Also, is there any contradiction for HT for smokers? 02 April 2019. Speaking of Women’s Health Nurse https://speakingofwomenshealth.com/askthenurse/smoking-and-hormone-therapy Accessed: 07 September 2021
  4. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT. Climacteric, 2016;19:4:314 https://www.imsociety.org/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 07 September 2021

Topic Last Updated: 07 September 2021 – Topic Last Reviewed: 07 September 2021
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