Who Should Avoid Hormone Therapy

**Who Should Avoid Hormone Therapy?**

Hormone replacement therapy (HRT) can help manage menopause symptoms like hot flashes and bone loss, but it’s not safe for everyone. Here’s a simple breakdown of who should avoid or use HRT cautiously:

**1. Breast Cancer Patients or Survivors**
HRT, especially estrogen-progestin combinations, may increase breast cancer risk[3][5]. Those with a history of breast cancer are generally advised to avoid HRT due to potential hormone-sensitive cancer recurrence[3][5].

**2. History of Blood Clots or Stroke**
Estrogen raises the risk of blood clots in veins (deep vein thrombosis) and lungs (pulmonary embolism)[1][3]. People with clotting disorders, recent strokes, or heart disease should avoid HRT[1][3].

**3. Liver Disease Patients**
The liver processes hormones, so existing liver conditions like hepatitis or cirrhosis may worsen with HRT due to added strain[^1^]. (*Note: While not explicitly covered in sources, this is widely recognized in medical guidelines.*)

**4. Unexplained Vaginal Bleeding**
Irregular bleeding before starting HRT needs investigation first[2][5], as it could signal uterine issues that hormones might exacerbate.

**5. Endometrial Cancer Risk Factors (Without Hysterectomy)**
Estrogen alone without progestogen increases endometrial cancer risk in those with a uterus[3]. Progestogen is added to lower this risk, but those predisposed to uterine cancers may still need alternatives[3][5].

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*Alternatives:* Non-hormonal options like antidepressants for hot flashes or lifestyle changes (diet/exercise) can help manage symptoms safely for those who can’t use HRT[^2^]. Always discuss risks with your doctor—side effects like headaches or nausea often fade within months if treatment continues[1][2], but long-term risks vary by health history.*

*(Sources cited inline from provided research; general medical knowledge included where gaps exist.)*