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Safety Issues and Other Uses for Hormone Replacement Therapy
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Women who use hormone replacement therapy are at increased risk for:
- Blood clots
- Heart attacks
- Strokes
- Breast cancer
- Gallbladder disease.
For a woman who still has her uterus (has not had a hysterectomy), taking estrogen alone without progesterone increases her chance of getting endometrial cancer (cancer of the lining of the uterus). Adding progesterone to the hormone therapy lowers this risk. For women who have had a hysterectomy, taking estrogen alone can raise the risk of blood clots and stroke.
Hormone replacement therapy may also cause the following side effects:
- Bleeding
- Bloating
- Breast tenderness or enlargement
- Headaches
- Mood changes
- Nausea.
Hormone replacement therapy is not appropriate for every woman dealing with the symptoms of menopause. Women who should not use HRT include those who:
- Think they are pregnant
- Have problems with vaginal bleeding
- Have had certain kinds of cancers, such as breast and uterine cancer
- Have had a stroke or heart attack
- Have had blood clots
- Have liver disease.
Hormone replacement therapy may be a way to get through the symptoms of menopause if taken for only a short time and in the smallest amount that produces results. However, hormones do not help prevent heart or bone disease, stroke, memory loss, or Alzheimer's disease. If you decide to use hormone replacement therapy, use it at the lowest dose that helps and for the shortest time needed. Check with your doctor every year to see if you still need HRT. Because there are both benefits and risks linked to this type of treatment, every woman should think about and discuss these issues with her doctor. The medical community is still trying to learn more about both the long-term and short-term effects of hormone replacement therapy on women's health.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD



