Menopause - Medications

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Highlights	Complications	Resources
Introduction	Lifestyle Changes	References
Symptoms	Medications

Adverse Effects of HRT

Heart Disease and Heart Attack. Giving HRT in order to prevent heart disease is not recommended. However, using HRT for a short period of time in younger women (ages 50 – 59 years) within 10 years after menopause does not appear to raise the risk for heart disease.

Stroke. HRT may increase the risk of stroke in some age groups. It is no longer recommended as a strategy to prevent stroke, either a first stroke or a second stroke.

Mental Decline. Reviews of the Women’s Health Initiative Memory Study, as well as other more recent studies, have found that combined HRT does not reduce the risk of cognitive impairment, and may actually increase the risk of cognitive decline.

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Thromboembolism. HRT is associated with a higher risk for thromboembolism, in which blood clots form in deep veins. This places women at risk for pulmonary embolism, in which the blood clot travels to the lungs.

Click the icon to see an image of a pulmonary embolism.

Breast Cancer. Many studies have reported a higher risk for breast cancer in postmenopausal women who take combination estrogen-progesterone hormone replacement therapy for more than 3 – 5 years The risk appears higher for women who begin EPT shortly after menopause. This risk declines somewhat within 3 years of stopping combination HRT.

Estrogen-only HRT (ET) does not significantly increase the risk of developing breast cancer if it is used for less than 10 years. If used for more than 10 years, it may increase the risk of breast (and ovarian) cancers, especially for women already at higher risk for breast cancer. The North American Menopause Society does not recommend ET use in breast cancer survivors as it has not been proven safe and may raise the risk of recurrence.

Both estrogen-only and combination HRT increase breast cancer density, making mammograms more difficult to read. This can cause cancer to be diagnosed at a later stage. Women who take HRT should be aware of the need for regular mammogram screenings.

The North American Menopause Society recommends that women who are at risk for breast cancer avoid hormone therapy and try other options to manage menopausal symptoms. Recent studies have noted that breast cancer rates have fallen as HRT use has declined.