Hormone Therapy 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”.1

Umbrella
What may the Hormone Therapy Risks Umbrella include?

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

  • Hormone Replacement Therapy (HRT) Risks
  • Hormone Therapy (HT) Risks
  • Menopausal Hormone Therapy (MHT) Risks

Date

What can it be important to be clear about with hormone therapy (HT) risks information?

It can be important to be clear about the date of all information including the date of HT risks information, because this information may have been updated.

Symptoms or Chronic Conditions

What can it also be important to be clear about with HT risks information?

It can also be important to be clear about whether HT risks information is about the use of HT for the management of menopausal symptoms such as hot flushes, night sweats and vaginal dryness or for the prevention of chronic conditions such as cardiovascular disease, cancer, dementia and osteoporosis.

One Size Fits All

Are different types of HT available?

No. In HRT – Types, Doses and Regimes the (British) Women’s Health Concern elaborate on:

“Many types of HRT are available and there is not one type, dose or regimen which suits all women. It is important to understand which hormones are used, why and how so that for each woman who chooses to take HRT, the treatment is individualised to best suit her needs, taking into account types of symptoms, medical history, period pattern if present and current national recommendations and guidelines”.2

Risks

What are some risks associated with HT?

In Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT?, last updated 08 September 2022, the (Australian) Jean Hailes for Women’s Health (JH) elaborate on:

“Research shows there are some risks associated with MHT. The risks of hormone therapy differ depending on:

  • The type of medication
  • The dose given
  • How long the medication is used for
  • How the medication is given (e.g. patch or tablet)
  • When medication is started
  • Whether a progestogen is used
  • The type of progestogen used”.3

Risks vs Benefits

Are the risks of HT generally outweighed by the benefits?

In Risks and Benefits of MHT: Supporting Women Making A Decision the Australasian Menopause Society elaborate on:

  • “The risks of MHT must be considered in perspective for each woman and balanced against the benefits, particularly the severity of symptoms
  • Management of menopausal symptoms should be tailored to the individual woman to effectively manage her symptoms and minimise risks
  • For some women any extra risk will be unacceptable but others may feel that the benefits outweigh the risks”.4

NICE Guidelines

What did the (British) National Institute for Health and Care Excellence’s (NICE) guidelines note about the benefits and risks of hormone replacement therapy (HRT)?

In Menopause: Diagnosis and Management – Information for the Public: Benefits and Risks of HRT, last Updated: 05 December 2019, the NICE explain and elaborate on:

“NICE looked at the risks of the following conditions in women taking HRT compared with women of menopausal age in the general population. Your GP should explain that the risks of the conditions described below vary from one woman to another and depend on many risk factors. In cases where HRT is said to increase risk this usually means a very small increase in most women.

  • Blood Clots (Venous Thromboembolism)…
  • Heart Disease and Stroke (Cardiovascular Disease)…
  • Breast Cancer…
  • Type 2 Diabetes…
  • Osteoporosis…
  • Loss of Muscle Strength…
  • Dementia…”.5

Who is a GP?

DotS and/or DotC (Depending on the Country) a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Younger Than 60 Years

Younger than 60 years, do the benefits of HT generally outweigh the risks?

On page one in Deciding About Hormone Therapy Use: Potential Risks, published July 2022, the North American Menopause Society (NAMS) elaborate on:

“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”.6

In Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT? the JH elaborate on:

“A recent comprehensive review of evidence on MHT found it is an effective and safe treatment for the relief of menopausal symptoms for healthy women. The data showed that MHT had low risks for women aged between 50 and 60 years, but more research is needed to understand how MHT might affect other women’s health issues”.7

Older Than 60 Years

Older than 60 years or postmenopausal for 10 years or more, is it recommended women do not start HT?

The JH note:


Hormone Therapy Risks
“It is not recommended you start MHT if you are older than 60 years or if you’ve been postmenopausal for 10 years or more”.8

After Age 65

In women older than 65 years, can starting HT increase the risk of dementia?

On page one in Deciding About Hormone Therapy Use: Potential Risks the NAMS explain:

“If started in women aged older than 65 years, HT might increase the risk of dementia”.9

Breast Cancer Risk

Can HT increase breast cancer risk?

On page one in Deciding About Hormone Use: Potential Risks the NAMS explain:

“Hormone therapy (combined estrogen and progestogen) might slightly increase your risk of breast cancer if used for more than 4 to 5 years. Using estrogen alone (for women without a uterus) does not increase breast cancer risk at 7 years but may increase risk if used for a longer time”.10

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 one of the recommendations is:

  • “Current evidence suggests that oestrogen alone HRT is associated with a lower risk of breast cancer than combined HRT. Breast cancer risk is duration dependent and may vary with the type of progestogen used. The risk of breast cancer should be considered in the context of the overall benefits and risks associated with HRT intake”.11

Not Advised

When may using HT not be advised?

The JH note:

“Your doctor may advise you not to use MHT if it could increase your health risks. For example, if you have:

  • Cancer (e.g. breast or uterine)
  • Undiagnosed vaginal bleeding
  • Heart disease”.12

Do Not Take

Which should HT not be takeen?

In Menopause: Medicines To Help You the (United States) Food and Drug Administration elaborate on:

“Do not take hormone therapy if you:

  • Have problems with vaginal bleeding
  • Have or have had certain cancers such as breast cancer or uterine cancer
  • Have or have had a blood clot, stroke or heart attack
  • Have a bleeding disorder
  • Have liver disease
  • Have allergic reactions to hormone medicine”.13

Health Care Provider

What if I choose to use HT, how can I find out what my risks and benefits are?

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

In BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women the British Menopause Society (BMS) and Women’s Health Concern (WHC) note:


Hormone Therapy Benefits and Risks“The decision whether to take HRT, the dose of HRT used and the 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”.14

On page one in Deciding About Hormone Use the NAMS explain:

“Every woman is different, and you will decide about whether to use HT based on the severity of your symptoms, your personal and family health history, and your own beliefs about menopause treatments. Your healthcare professional will be able to help you with your decision”.15

In Menopause: Diagnosis & Treatment – Treatment: Hormone Therapy the (United States) Mayo Clinic note:

“Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change”.16

Health Topics A-Z

Where may I find Health Topics related to Hormone Therapy Risks?

In Health Topics A-Z may find:

Health Topics A-Z

Links

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Your Country may have Links similar to:

Links

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New or Updated

  1. 20 Years of Data Lead To Changes In Perceptions, Usage of Menopausal HT
  2. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  3. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women
  4. BMS, IMS, EMAS, RCOG and AMS Joint Statement on Menopausal Hormone Therapy and Breast Cancer Risk In Response To EMA Pharmacovigilance Risk Assessment Committee Recommendations In May 2020
  5. Bioidentical Hormones Explained – A British Menopause Society Video
  6. Bioidentical Hormones: Are They Safer?
  7. Combined Menopausal Hormone Therapy (MHT)
  8. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  9. Consumer Health: Menopause, Hormone Replacement Therapy and Heart Health
  10. Deciding About Hormone Therapy
  11. Deciding About Hormone Therapy Use
  12. EMAS Menopause Essentials
  13. EMAS Replay [Webinars]
  14. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  15. Estrogen & Hormones
  16. Estrogen & Hormones: Postmenopausal Hormone Replacement Therapy
  17. Family History
  18. Find A Menopause Practitioner [United States and Other]
  19. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  20. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  21. HRT
  22. HRT and Breast Cancer: Overall Risks and Benefits Explained – A British Menopause Society Video
  23. HRT and the Risk of Breast Cancer Explained – A British Menopause Society Video
  24. HRT – Types, Doses and Regimens
  25. HRT: Benefits and Risks
  26. Hormone Replacement Therapy
  27. Hormone Replacement Therapy (HRT)
  28. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  29. Hormone Replacement Therapy (HRT): Benefits and Risks
  30. Hormone Replacement Therapy (HRT): Overview – Risks and Side Effects of HRT
  31. Hormone Therapy In Postmenopausal Persons: Primary Prevention of Chronic Conditions
  32. Hormone Replacement Therapy Safe, Despite Rare Blood Clot Risks From Tablets
  33. Hormone Therapy for Menopause
  34. Hormone Therapy: Is It Right for You?
  35. Hot Flashes
  36. Hot Flashes
  37. Hot Flashes: What Can I Do? [+ Video: What Are the Signs and Symptoms of Menopause?]
  38. How To Find Relief for Hot Flashes At Night
  39. Index To Drug-Specific Information [United States]
  40. 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
  41. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Hormone Replacement Therapy (HRT) [+ Video: Is HRT Bad for You?]
  42. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Signs and Symptoms [+ Video: Talking Menopause With Your GP]
  43. Learning To Cope With Hot Flashes
  44. MHT and Breast Cancer Risk
  45. Making Choices At Menopause
  46. Making Sense of Menopausal Hormone Therapy Means Understanding the Benefits As Well As the Risks
  47. Mayo Clinic Minute: Help With Hot Flashes Due To Menopause [+ Video]
  48. Menopausal Hormone Therapy
  49. Menopausal Hormone Therapy and Breast Cancer Risk
  50. Menopausal Hormone Therapy and Venous Thromboembolism
  51. Menopausal Hormone Therapy and Women’s Health: An Umbrella Review
  52. Menopausal Hormone Therapy, Heart Disease and Stroke
  53. Menopause
  54. Menopause
  55. Menopause
  56. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  57. Menopause Hormone Therapy and Your Heart
  58. Menopause Hormone Therapy and Your Heart: How To Limit the Risks
  59. Menopause Hormone Therapy: Does It Cause Vaginal Bleeding?
  60. Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Benefits of MHT?
  61. Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT?
  62. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
  63. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  64. Menopause Patient Information [Videos] 3. The Risks & Benefits of HRT
  65. Menopause Patient Information [Videos] 4. The Different Types of HRT
  66. Menopause Preparedness Toolkit Video Series: Treating Vasomotor Symptoms of Menopause
  67. Menopause Symptoms and Relief
  68. Menopause Treatment
  69. Menopause – Is Menopausal Hormone Therapy (HRT) Safe? [Multiply Languages] [Video]
  70. Menopause: Diagnosis & Treatment
  71. Menopause: Diagnosis and Management – Information for the Public: Benefits and Risks of HRT [NICE Guideline]
  72. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  73. Menopause: Medicines To Help You
  74. Menopause: Menopause – Hormone Treatments
  75. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  76. National Center for Complementary and Integrative Health: Know the Science: How Medications and Supplements Can Interact
  77. National Center for Complementary and Integrative Health: Menopausal Symptoms In Depth
  78. Oestrogen Only Menopausal Hormone Therapy
  79. Revised Global Consensus Statement on Menopausal Hormone Therapy
  80. Risks and Benefits of MHT
  81. Study IDs Non-Hormonal Options for Menopause Symptoms
  82. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement
  83. The North American Menopause Society Statement on Continuing Use of Systemic Hormone Therapy After Age 65
  84. Tips To Help Manage Menopause Symptoms
  85. Topical Estrogens and Non-Hormonal Preparations for Postmenopausal Vulvovaginal Atrophy: An EMAS Clinical Guide
  86. Types of Hormone Therapy
  87. Venous Thrombosis/Thromboembolism Risk and Menopausal Treatments
  88. Video Series-2020: What You Need To Know About Bioidentical Hormone Therapy
  89. Video Series-2021: Treatment Options for Vaginal Dryness and Urinary Issues
  90. Video Series-2021: What Women Need to Know About Hormone Therapies
  91. Video Series-2022: Hormone Therapy: Understanding the Risks and Benefits
  92. Video Series-2022: Perimenopause, Signs, Symptoms, and Solutions
  93. Videos and Podcasts: Interviews and Podcasts – Interviews: Prevention of Chronic Diseases In Women: Where Does MHT Fit In
  94. Videos and Podcasts: Interviews and Podcasts – Interviews: The Women’s Health Initiative – What Can We Believe
  95. Webinars: Previous – 2021 Vision: Practical Steps to Optimize Your Benefit-Risk. Discussions for A New Decade
  96. Webinars: Previous – Breast Cancer
  97. Webinars: Previous – The Early Menopausal Patient
  98. What Are the Benefits and Risks of HRT?
  99. What Everyone Should Know About Menopause Symptoms

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Deciding About Hormone Therapy Use: Potential Risks. July 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 16 December 2022
  2. HRT – Types, Doses and Regimes. Published Date: September 2021. British Menopause Society https://www.womens-health-concern.org/help-and-advice/factsheets/hrt-types-doses-and-regimens/ Accessed: 16 December 2022
  3. Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT? Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 16 December 2022
  4. Risks and Benefits of MHT: Supporting Women Making A Decision. Content Updated January 2021. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/risks-and-benefits-of-mht-hrt Accessed: 16 December 2022
  5. Menopause: Diagnosis and Management – Information for the Public: Benefits and Risks of HRT. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Benefits-and-risks-of-HRT Accessed: 16 December 2022
  6. Deciding About Hormone Therapy Use: Potential Risks. July 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 16 December 2022
  7. Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT? Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 16 December 2022
  8. Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT? Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 16 December 2022
  9. Deciding About Hormone Therapy Use: Potential Risks. July 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 16 December 2022
  10. Deciding About Hormone Therapy Use: Potential Risks. July 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 16 December 2022
  11. 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: 16 December 2022
  12. Menopause Management Options: Menopausal Hormone Therapy (MHT) – What Are the Risks of MHT? Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 16 December 2022
  13. Menopause: Medicines To Help You. Content Current As of: 22 August 2019. Food and Drug Administration https://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118627.htm Accessed: 16 December 2022
  14. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women. Updated March 2021. British Menopause Society and Women’s Health Concern https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/ Accessed: 16 December 2022
  15. Deciding About Hormone Therapy Use: Potential Risks. July 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 16 December 2022
  16. Menopause: Diagnosis & Treatment – Treatment: Hormone Therapy. 14 October 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 16 December 2022
Topic Last Updated: 16 December 2022 – Topic Last Reviewed: 16 December 2022

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