You should not use HRT if you have any of the following:

Undiagnosed abnormal genital bleeding
DVT or PE (current or history of)
Active or history of arterial thromboembolic disease (e.g., stroke, myocardial infarction)
High risk of cardiovascular disease
Breast cancer (current or history of)
Estrogen-dependent tumor (known or suspected)
Active hepatic impairment or disease
Known protein C, protein S, antithrombin deficiency, Factor V Leiden, or other known thrombophilic disorder
Pregnancy
HRT is not contraception (it will not prevent pregnancy). If you require contraception please inform your doctor.

Medication uses in menopausal women

Estrogen alleviates hot flashes by directly influencing the hypothalamus, which is the brain’s temperature regulation center.
Progesterone protects against uterine cancer and precancer in people with an intact uterus taking estrogen.
Estrogen is also prescribed to prevent osteoporosis in some women.

Benefits

Estrogen alleviates moderate to severe symptoms associated with menopause, most notably vasomotor symptoms (e.g., hot flashes). Progesterone prevents the development of endometrial cancer in people using estrogen for the relief of menopausal symptoms.
Some studies suggest that estrogen and progesterone have a cardioprotective effect when initiated during a specific timeframe.
Estrogen is also associated with improvements in bone density.

Risks

Endometrial cancer, which can be mitigated by adding progesterone.
Heart attack, stroke, or venous thromboembolism.
Increased breast density in some women, which may make it more challenging to detect abnormalities on mammograms, require additional imaging, and can slightly increase the risk of breast cancer.
Compounded hormones are not evaluated by the FDA for safety or efficacy. People may avoid compounded products to avoid this risk.
Increased risk of dementia in women over 60.

Common side effects

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Reach out to your doctor through in-app messaging or get medical help if any of these side effects or any other side effects bother you or do not go away:

Breast tenderness
Headache
Mood changes
Bloating
Irregular bleeding
Nausea

Rare adverse events

Severe allergic reaction (anaphylaxis)
Heart attack, stroke, or venous thromboembolism
Breast cancer or endometrial cancer
Allergic reactions (e.g., rash, hives, swelling, difficulty breathing)
Blood clots (deep vein thrombosis or pulmonary embolism)
Stroke
Gallbladder disease
Severe headaches
Liver abnormalities
Vision changes (e.g., retinal vascular thrombosis)
Severe mood changes or depression
Unusual breast changes (e.g., lumps, severe tenderness)
Ovarian cancer
Endometrial hyperplasia or cancer
Skin reactions (e.g., erythema multiforme, urticaria)

Alternatives to HRT for menopause therapy

No treatment
Nonhormonal therapy including medications (e.g., SSRI, gabapentin, NK3 antagonists), supplements, behavioral interventions (e.g., CBT) and lifestyle changes
Alternative FDA-approved treatments such as vaginal, oral, or other transdermal hormone preparations like gels or sprays
Other compounded medications

Below, please acknowledge that you:

Reviewed the risks and benefits above
Consent to receiving menopause hormone therapy

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