NICE guidelines state that for the majority of women, the benefits of taking HRT outweigh the risks. For each individual woman this decision is based on your personal and medical history, any pre-existing medical conditions, your family history and whether or not you still have a womb (uterus).
Many women worry about breast cancer and blood clots.
Your personal breast cancer risk depends on many things including age, family history, age at puberty, number of pregnancies etc. Lifestyle factors play an important role in breast cancer risk with obesity, smoking and alcohol consumption of 2 or more units per day all increasing breast cancer risk while regular moderate exercise of 2 ½ hours per week reduces this.
Studies have shown that women who take estrogen-only HRT do not have an increased risk of breast cancer. Women who take combined HRT, containing estrogen and progestogen, may have a small increased risk of breast cancer. This risk can be minimised by using Body Identical HRT (estrogen through the skin in combination with micronised progesterone if required) as some studies have shown the risk of breast cancer with HRT is reduced if micronised progesterone is used.
There are many risk factors for blood clots and the risk increases as you age. HRT taken orally as a tablet is associated with a small increased risk of blood clot, for this reason and should be avoided in anyone with an increased risk of blood clot such as a personal history of blood clot, liver disease or migraine. Evidence shows that HRT taken transdermally across the skin as an estrogen patch, gel or spray carries no increased risk of blood clot.
Ovarian cancer and gall bladder disease – small increased risk.