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"Understanding the Eligibility Criteria for Menopause Hormone Therapy"

Risk and benefit criteria for menopause hormone therapy
Make sure your benefits outweigh risks to your health

Menopause hormone therapy is something I spend a lot of time discussing with patients. it's a great option for so many women to help with symptoms ranging from hot flashes, night sweats, mood issues, insomnia, muscle and joint pain, vaginal dryness, metabolic issues, and can even help reduce risk of conditions such as osteoporosis and cardiovascular events. Quite the jack-of-all-trades! Should you sign up right away? Is everyone able to use hormone therapy? This blog briefly outlines who should and shouldn't consider using this specific protocol for menopausal symptoms.

There are a lot of factors that go into determining whether the risks outweigh the benefits to starting hormone therapy. I don't want to oversimplify them here but I know after reading about all the benefits it's easy to get excited and you want to find out if it's an option for yourself.

Benefits Likely Outweigh The Risks of Hormone Therapy

Are you ready? Your benefits of hormone therapy are much greater than any risks associated if you are:

  • less than 60 years old

  • it's been less than 10 years since your periods stopped

  • normal weight

  • normal blood pressure

  • you're active

  • Cardiovascular risk assessment score is less than 5%

If that sounds like you then it's worthwhile discussing with your healthcare provider more about MHT.

Risks Outweigh The Benefits of Hormone Therapy

Unfortunately there are some people who have absolute contraindications to using hormone therapy. Here are a few of the health factors that may mean you should avoid hormone therapy, or that the risks involved outweigh the benefits:

  • You have/had breast cancer

  •  You have had a stroke

  • You have had a TIA (transient ischemic attack)

  • You have had a heart attack

  • You have had endometrial cancer

  • you have an active liver disease

  • You have unexplained vaginal bleeding (still under investigation)

  • Untreated hypertension (high blood pressure)

  • Cardiovascular risk assessment tool value is greater than 7.5%

  • You have a known clotting disorder - risk reduced if you use transdermal estrogen instead of oral

What about Everyone Else?

There is a lot of grey in-between these two groups! There is a bunch of people who fall into the 'Moderate Risk' category and you really need your healthcare provider to help determine the best course of action. Some conditions (such as high triglycerides or active gallbladder disease) have a lower risk profile if you use transdermal estrogen instead of oral. Some lifestyle choices like smoking will reduce the benefits of MHT.

Why do those conditions increase the riskiness of hormone therapy?

This is my favourite question. We have this wonderful therapy but as with most things it does have its own risks associated. I'll be dedicating my next blog post to this entire topic so stay tuned.


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