The benefits of hormone therapy for menopause symptoms often outweigh the risks for many people. However, it may not be a good treatment option for others, including those with a history of blood clots or certain types of cancer.

Hormone therapy involves taking estrogen, progesterone, or both. It’s a safe and effective way to manage menopause symptoms for many people.

However, the benefits and risks may differ depending on which hormones you take, how long you take them, and whether you have or have had certain conditions.

If you’re not sure whether hormone therapy is right for you, talk with a qualified healthcare professional. The decision on whether the benefits of hormone therapy outweigh the risks is an individual one that you must make with your doctor.

The breast cancer risks associated with hormone therapy can vary depending on many factors, including which hormones the therapy contains and your health history. For people with a current or previous history of estrogen-sensitive breast cancer, systemic hormone therapy may not be a good option.

Estrogen-sensitive breast cancer, also called estrogen receptor-positive breast cancer, relies on estrogen to grow.

If you have or have had this type of cancer, your doctor may recommend avoiding systemic hormone therapy (hormone therapy that absorbs into your bloodstream and affects your whole body).

In some cases, people with a history of breast cancer can take topical vaginal estrogen to relieve symptoms like vaginal dryness or irritation. But again, this depends on the specific circumstances. Talk with your doctor about the benefits and risks.

In many cases, experts may not recommend hormone therapy for people with a current or previous history of other cancers that are sensitive to estrogen, including endometrial cancer.

However, 2020 guidelines note that it may be an option for people with early stage endometrial cancer or those who have had a hysterectomy.

You and your doctor must discuss the benefits and risks for your specific situation.

People with a personal or family history of blood clots must talk with their doctor about whether hormone therapy may be safe for them. Hormone therapy can increase blood clot risk, but the increase may be small and can depend on the formulation, dose, and administration.

For example, low dose hormone therapy may come with less risk. Similarly, transdermal (absorbed through your skin) forms, like the patch, may be safer than oral forms.

Talk with your doctor if you have a history of or may be at an increased risk of:

Talk with your doctor if you want to try hormone therapy and have a previous or current history of any other conditions, including:

  • gallbladder disease
  • liver disease
  • heart disease or other heart conditions

These conditions may affect the type or dose of hormone therapy you can take.

It may be safer to start hormone therapy for menopause symptoms before you turn 60 years old. According to the National Health Service (NHS), the risks may outweigh the benefits after that age.

It may also be safer to begin treatment less than 10 years after the onset of menopause.

If you still need treatment to manage your symptoms past 60 years old or more than 10 years after menopause begins, your doctor may recommend:

  • taking a low dose of hormone therapy
  • using local forms of hormone therapy rather than systemic forms
  • trying an alternative treatment method

Certain risks, including the risk of breast cancer, may also increase the longer you take hormone therapy. Your risks can decrease after you stop taking it, so ask your doctor how long you can take it.

The bottom line

Many factors can affect whether hormone therapy is right for you. It comes down to whether the benefits outweigh the risks for your specific situation.

If you have a current or previous history of any chronic conditions, be sure to discuss the conditions with your doctor. They need to have a full understanding of your medical history to help determine whether hormone therapy may be right for you.

Learn more about the benefits and risks of menopausal hormone therapy.

Menopausal hormone therapy can be helpful for many people, but knowing whether it’s right for you can be hard. Some people, including those with a history of certain cancers or conditions related to blood clots, may want to avoid it if possible.

If you need help determining whether to try hormone therapy, talk with a healthcare professional. They can help you get started or recommend an alternative management method for menopause symptoms.

Want to connect with us?

Visit our Menopause resource center or sign up for our Menopause newsletter.