“Hormone therapy might slightly increase
your risk of stroke or blood clots in the legs or lungs
(especially if taken in pill form)”.1

Umbrella

What may the Hormone Therapy and Stroke Umbrella include?

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

  • Cardiovascular Disease
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Therapy (MHT)
  • Stroke

Cardiovascular Disease

What is cardiovascular disease (CVD)?

DotS the definition of CVD may vary. In Cardiovascular Heart Disease: What Cardiovascular Disease Is the British Heart Foundation’s (BHF) definition is:

“Cardiovascular disease (CVD), also called heart and circulatory disease, is the general name for conditions that affect your heart or circulation. These include high blood pressure, stroke and vascular dementia”.2

Stroke

What is a stroke?

DotS the definition of a stroke may vary. The American Stroke Association’s definition is:

“A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die”.3

Primary Ovarian Insufficiency and Premature or Early Menopause

Is HT recommended for women with primary ovarian insufficiency and premature or early menopause?

On page one in The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement, published 07 July 2022, the North American Menopause Society (NAMS) (now the Menopause Society explain:

  • “Women with primary ovarian insufficiency and premature or early menopause have higher risks of bone loss, heart disease, and cognitive or affective disorders associated with estrogen deficiency. It is recommended that hormone therapy can be used until at least the mean age of menopause unless there is a contraindication to its use”.4

Risk

What is the risk of stroke associated with HT?

On page one in Deciding About Hormone Therapy Use: Potential Benefits, published July 2022, the NAMS explain:


Hormone Therapy and Stroke“As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks. Hormone therapy might slightly increase your risk of stroke or blood clots in the legs or lungs (especially if taken in pill form)”.5

In Menopausal Hormone Therapy, Heart Disease and Stroke the European Menopause and Andropause Society note:

  • “MHT may confer a small risk of stroke, more so with oral than with transdermal estrogen”.6

On page seven of Menopause and Menopause Hormone Therapy: 4. Why Is MHT Important? What Are the Risks? the International Menopause Society’s (IMS) Leaflet for Women for World Menopause Day 2024, the IMS include:

“While MHT offers many benefits, there are some small risks:

  • Hormone Therapy and StrokeBreast cancer: There is a slight increase in risk, especially with long-term use
  • Blood clots: This risk is higher with certain forms of MHT, like tablets
  • Stroke: Older women or those with certain health conditions may be at higher risk

It’s important to have a personalized discussion with your healthcare professional to understand how these risks apply to you”.7

Chronic Disease

Is HT recommended for the prevention of stroke?

On page four in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published online 10 June 2022, one of the recommendations is:

  • “HRT should not be recommended for the primary or secondary prevention of chronic disease in women experiencing the menopause in keeping with national and international guidelines”.8

Health Care Provider

If I choose to use HT what is my risk of stroke?

Different women who choose to use HT can have different risks of stroke. It may therefore be in your best interest to also choose to talk to your health care provider about this.

On page two in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause another of the recommendations is:

  • “The decision whether to take HRT, the dose and duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient. This should be considered in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use”.9

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Sources

  1. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement. 07 July 2022. North American Menopause Society https://menopause.org/wp-content/uploads/press-release/ht-position-statement-release.pdf Accessed: 27 December 2024
  2. Cardiovascular Heart Disease. Page Last Reviewed: December 2024. British Heart Foundation https://www.bhf.org.uk/informationsupport/conditions/cardiovascular-heart-disease Accessed: 27 December 2024
  3. About Stroke. American Stroke Association https://www.stroke.org/en/about-stroke Accessed: 27 December 2024
  4. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement. 07 July 2022. North American Menopause Society https://menopause.org/wp-content/uploads/press-release/ht-position-statement-release.pdf Accessed: 27 December 2024
  5. Deciding About Hormone Therapy: Potential Risks. July 2022. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 27 December 2024
  6. Menopausal Hormone Therapy, Heart Disease and Stroke. 2022. European Menopause and Andropause Society
    https://emas-online.org/wp-content/uploads/2022/05/Menopausal-hormone-therapy-heart-disease-and-stroke.pdf Accessed: 27 December 2024
  7. Menopause and Menopause Hormone Therapy: 2. Why Is MHT Important? What Are the Risks? 2024:7. International Menopause Society https://www.imsociety.org/wp-content/uploads/2024/10/2024-WMD-Leaflet_English.pdf Accessed: 27 December 2024
  8. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:3-4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 27 December 2024
  9. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:2. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 27 December 2024
Topic Last Updated: 09 February 2025 – Topic Last Reviewed: 27 December 2024