Contraindications of Hormone Replacement Therapy

Modern-day natural hormone replacement therapy is very flexible and safe and only a minority of menopausal women is told by their doctors that they should avoid it. However, if you suffer from, or have a history of cancer and severe liver disease, you will probably be advised never to take estrogen.

Your physician will discourage you to take hormone replacement if you have an estrogen-sensitive cancer, such as breast or endometrial cancer. They are generally reluctant to give estrogen to menopausal women who have previously been treated for uterine cancer, because it is possible may stimulate the distant spread of the cancer. However, if the cancer was detected in the early stages and was determined to be of a less aggressive type and if the patient has remained cancer-free for many years, some doctors feel that is safe o prescribe estrogen in small doses if a menopausal patient complains of severe symptoms of estrogen deficiency. Some menopausal women who have been successfully treated for breast cancer find that they are unable tot tolerate a complete lack of sex hormones in their bodies and hormone replacement therapy regimen using small doses of estrogen and larger doses of progesterone can often be worked out for them. They may opt to take this type of therapy after weighing all the pros and cons with a cancer specialist. If the cancer has been completely removed and there is no sign of invasion into the blood vessels and the lymph glands in the armpits are free of cancer, there is approximately a 75 percent chance of a complete cure. Taking hormone replacement does not dramatically affect this figure. A post menopausal cancer patient may live another 20 to 30 years after successful treatment for breast cancer and she may not want to run the increased risk of bone fracture or heart attack that may ultimately occur in the absence of estrogen in her body.

Severe liver disease, such as cirrhosis may also be a contraindication for hormone replacement therapy. Severe liver disease makes it difficult for your liver to break down or metabolize estrogen. Normal doses of estrogen replacement usually overtax a diseased liver so that liver function may worsen. Mild to moderate liver disease is not necessarily a contraindication to estrogen replacement, although in such a case it is wise you use only estrogen patches or vaginal estrogen, as these are most unlikely to overwork your liver. It is best to avoid oral estrogens in all cases of liver disease. If you have liver disease, you will need to consult your gastroenterologist about the type of liver disease you have. A blood test may be used to confirm the presence of a liver disease.

There are several other medical problems that make many doctors think twice before prescribing estrogen replacement therapy to their menopausal patients. They are not, however, absolute reasons that you cannot take this form of treatment; you can, but extra vigilance and care is called for. These are: recent and severe blood clots and thrombosis, severe high blood pressure that is difficult to control with antihypertensive medications, fibroids or endometriosis, gallbladder disease, benign breast disease and systemic lupus erythematosus. If you are suffering from menopausal symptoms but feel that estrogen replacement therapy is too dangerous for you, you may increase the amount of foods in your diet that are sources of natural estrogens.