Risks you should know about before starting hormone therapy.

Cancer of the uterine lining (endometrial cancer)

In a woman who still has a uterus, using estrogen without a progestogen increases the risk of cancer of the uterine lining. This is why a clinician generally prescribes a progestogen along with estrogen for a woman who has not had a hysterectomy.

Report any unusual vaginal bleeding to your clinician right away. Unexplained vaginal bleeding needs to be evaluated.

Blood clots, stroke, and heart disease

Systemic hormone therapy has been associated with an increased risk of blood clots in the legs and lungs, stroke, and, in some populations, heart attack. Risk varies with age, how long it has been since menopause, the type of hormone therapy, and your personal and family medical history.

Hormone therapy should not be used to prevent heart disease.

Breast cancer

Estrogen plus progestin therapy has been associated with an increased risk of invasive breast cancer. Risk appears to increase with longer duration of use.

Hormone therapy is not prescribed to a person with a current or past diagnosis of breast cancer or another hormone-sensitive cancer. Tell your clinician about any personal or family history of breast or ovarian cancer, and keep up with the breast screening your clinician recommends.

Dementia

In studies of women 65 years of age and older, hormone therapy was associated with an increased risk of probable dementia.

Hormone therapy should not be used to prevent dementia.

Conditions that may change what is appropriate for you

Tell your clinician if you have or have had: high blood pressure, high triglycerides, diabetes, gallbladder disease, liver problems, migraine headaches (particularly migraine with aura), seizures, asthma, thyroid disease, kidney problems, low or high calcium levels, lupus, or a history of endometriosis or uterine fibroids.

Also tell your clinician if you smoke or vape nicotine, if you are pregnant, trying to become pregnant, or breastfeeding, and about every prescription medication, over-the-counter medication, and supplement you take.

Common side effects

Side effects reported with hormone therapy include, among others:

• Headache
• Breast tenderness or pain
• Irregular vaginal bleeding or spotting
• Nausea and vomiting
• Stomach or abdominal cramps and bloating
• Fluid retention
• Mood changes
• Vaginal discharge
• Hair loss

This is not a complete list. Tell your clinician about any side effect that bothers you or does not go away.

When to seek care right away

Call 911 or seek emergency care if you experience:

• Chest pain, or pain spreading to the jaw, neck, or arm
• Sudden shortness of breath, or coughing up blood
• Pain, swelling, warmth, or redness in a leg
• Sudden severe headache, confusion, trouble speaking, or weakness or numbness on one side of the body
• Sudden vision changes or loss of vision
• Yellowing of the skin or eyes
• Unusual or unexplained vaginal bleeding

How hormone therapy is prescribed

When a clinician determines that hormone therapy is appropriate, it is generally prescribed at the lowest effective dose and for the shortest duration consistent with your treatment goals and your individual risks. Your clinician should reassess with you periodically whether continuing treatment is still appropriate.

Hormone therapy is not approved for, and should not be used for, preventing heart disease or dementia.

Reporting side effects

Tell your clinician about any side effect. You may also report side effects of prescription medications to the U.S. Food and Drug Administration at 1-800-FDA-1088 or at fda.gov/medwatch.

Questions

Email care@joinsoha.com, or read our treatments page and FAQ.