Who Should (and Shouldn't) Consider Hormone Therapy?
Who Should (and Shouldn't) Consider Hormone Therapy?
Navigating the Decision
Menopausal hormone therapy can be a game-changer for some women, but it's not for everyone. This article outlines current guidelines on who might benefit from hormone therapy and who should avoid it.
Contents
- Ideal Candidates for Hormone Therapy
- Who Should Avoid Hormone Therapy
- Special Considerations
Ideal Candidates for Hormone Therapy
According to current guidelines, hormone therapy is generally considered safe for healthy women who are within 10 years of menopause or younger than 60. These women should be experiencing significant menopause symptoms that impact their quality of life. The therapy should be used at the lowest effective dose for the shortest time needed to relieve symptoms. Women without a uterus can use estrogen alone, while those with a uterus need combined estrogen-progestin therapy.
Who Should Avoid Hormone Therapy
Certain women should not use hormone therapy due to increased health risks. This includes women with a history of breast cancer, coronary heart disease, previous blood clots or stroke, or active liver disease. Women who are more than 10 years past menopause or older than 60 should generally avoid starting hormone therapy, as the risks may outweigh the benefits. Long-term use for disease prevention is not currently recommended for any group.
Special Considerations
Some groups require careful consideration. Women with a family history of breast cancer should discuss their individual risk factors with their doctor. Those who have had their ovaries removed before age 45 (primary ovarian insufficiency) may have different considerations and potential benefits from hormone therapy. For BRCA1/2 gene carriers who've had risk-reducing surgery, the decision requires careful discussion of risks and benefits.
FAQs
Can I use hormone therapy if I'm over 60?
Generally not recommended to start after 60.
Is hormone therapy safe if I smoke?
Smoking increases risks; quitting is strongly advised.
How long can I safely use hormone therapy?
Shortest time needed; reassess annually with your doctor.
Are there alternatives to hormone therapy?
Yes, discuss non-hormonal options with your doctor.
Can I use hormone therapy for osteoporosis prevention?
Not recommended as the primary reason for long-term use.
The Bottom Line
Hormone therapy can be beneficial for some women, but it's crucial to make an informed decision based on individual health factors and current guidelines.
Additional References
- The North American Menopause Society. Menopause 2022; 29:767.
- Stuenkel CA, et al. J Clin Endocrinol Metab 2015; 100:3975.
- Manson JE, et al. JAMA 2013; 310:1353.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.