Who shouldn't take hormone replacement therapy?

If you are wondering whether hormone therapy is off the table for you, the answer starts with your full medical history.

Who can rule hormone therapy in or out

Only a prescriber with your full history can rule hormone therapy in or out for you. Ask what in your history would change that answer, and have the reasoning written out.

History that can change the answer

Bring a complete history to the visit. Include any cancer, blood clots, stroke, heart or liver conditions, current or possible pregnancy, and all the medicines and supplements you use. Then ask which of these affect whether you can start.

If something on your list worries you, raise it first instead of waiting for the prescriber to ask. Use these questions:

• Which items in my history make this a poor fit, and which only need monitoring?
• What testing do you want first, and how often afterward?
• At what point would you end treatment?

For the current professional framing of who hormone therapy suits, read ACOG's broadened guidance on managing menopause symptoms. If age is your worry, read a Menopause Society statement that ongoing individualized hormone therapy appears to have no age limit. Both are society statements, not a ruling on your history, so ask your prescriber how each applies.

If a prescriber says no

Ask for the reasons spelled out if you are declined. If you are unsure, ask for a second opinion from another prescriber or your own physician. For anything that feels like an emergency, call emergency services.

One person, one decision

A prescriber decides this patient by patient.