Is HRT safe?

HRT is generally very safe to take. As with all medications, there is the potential for risk, but we have a very good understanding of those risks, and who HRT wouldn’t be suitable for.
The risks of HRT depend on the type and dose of HRT you are given and other individual factors such as your age, weight, general health and lifestyle.

In low-risk women and if started within 10 years of menopause or below the age of 60, the benefits of HRT usually outweigh the small risks.

HRT and Breast Cancer

If you’ve had breast cancer, HRT is unlikely to be suitable for you.

Combined HRT and breast cancer

Combined HRT (which is oestrogen combined with progesterone, typically taken if you still have a womb) slightly increases the risk of breast cancer. It’s thought that if you take HRT for many years, the risk is greater than if you take it for just a few months. When it’s discontinued, the risk drops.

Combined HRT also slightly increases the risk of developing ovarian cancer.

Synthetic progestogens (not body identical) used in combined HRT have been shown to cause a small increased risk of breast cancer in women over and above women not using HRT.

To put this into context, out of 1,000 women aged 50-59 in the UK, we would anticipate that 23 of them would be diagnosed with breast cancer over five years.

If these 1,000 women were to take combined HRT for 5 years, there may be 4 extra cases of breast cancer occurring within the group. As a comparison, drinking more than 2 units of alcohol per day would lead to an extra 5 cases of breast cancer within the group, and if all 1,000 women were obese, there would be an additional 24 cases of breast cancer.

Oestrogen-only HRT and breast cancer

Women taking oestrogen-only HRT (e.g. who have had a hysterectomy) statistically, have not been shown to have an increased risk of breast cancer.

Other risks

Oral HRT very slightly increases the risk of stroke in women over 60, but there’s no increased risk with transdermal HRT (such as patches, gels and sprays).

HRT can have a positive effect on our risk of heart disease. Studies have shown that women who start oestrogen hormone replacement therapy before the age of 60 or within 10 years of menopause have a lower risk of heart disease than those who don’t.

Safety of testosterone

Some women may benefit from taking testosterone for their menopause symptoms. Testosterone is safe when used in a transdermal form, and it doesn’t tend to increase blood pressure or adversely affect cholesterol and blood lipids. We still don’t know how safe it is for women who have had breast cancer to use testosterone.