The North American Menopause Society’s (menopause.org) 2012 Position Statement on Hormone Therapy (HT) provides the following guidelines:
• HT remains the most effective treatment available for menopausal symptoms, including hot flashes and night sweats that can interrupt sleep and impair quality of life. Many women can take it safely.
• If you have had blood clots, heart disease, stroke, or breast cancer, it may not be in your best interest to take HT. Be sure to discuss your health conditions with your healthcare provider.
• How long you should take HT depends on whether you take estrogen alone or a combination of estrogen and progesterone. For combination therapy, the time is limited by the increased risk of breast cancer that is seen with more than three to five years of use. For estrogen alone, no sign of an increased risk of breast cancer was seen during an average of seven years of treatment, a finding that allows more choice in how long you choose to use estrogen therapy.
• Most healthy women below age 60 will have no increase in the risk of heart disease with HT. The risks of stroke and blood clots in the lungs are increased but, in these younger age groups, the risks are less than 1 in every 1,000 women per year taking HT.
• Estrogen therapy delivered through the skin (by patch, cream, gel, or spray) and low dose oral estrogen may have lower risks of blood clots and stroke than standard doses of oral estrogen, but all the evidence is not yet available.