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The only contraindications to hormone therapy are undiagnosed postmenopausal bleeding, active liver disease, a personal history of breast cancer, or an estrogen-dependent cancer like endometrial or uterine cancer. If you’ve had a blood clot in your legs or lungs, have a genetic predisposition to blood-clotting, or have a history of heart attack or stroke, in most cases these can be contraindications; however, even these risks can be minimized with the type, dose, and mode of delivery. Not a family history of heart disease (if anything, that would be a reason to take HT, as it has been shown to reduce the risk of death from heart disease). Not a family history of breast cancer, which is a big one because I think if you had to ask, “What is the reason why most women do not want to take hormone therapy or fear it?” it is the fear of breast cancer. And women didn’t make that up. That came from the Women’s Health Initiative, which reported a slightly higher risk of breast cancer in women who took estrogen and progestin. In reality, the discussion about the association of breast cancer and menopausal hormone therapy is much more nuanced.
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Tamsen Fadal (How to Menopause: Take Charge of Your Health, Reclaim Your Life, and Feel Even Better than Before)