Contraindications to prescribing hormone replacement therapy (HRT) include a history of breast cancer, endometrial cancer, ovarian cancer, or other hormone-sensitive cancers, as HRT is not routinely offered to women with a history of breast cancer. NICE CKS
Women with contraindications such as hormone-sensitive cancers should be advised against HRT. NICE CKS
Risks associated with HRT include a slight increase in endometrial cancer risk with sequential combined HRT, especially with longer duration of use, higher estrogen doses, or fewer days of progestogen per cycle. NICE CKS
There is a very slight increase in ovarian cancer risk with combined HRT in women with ovaries. NICE CKS
HRT does not increase the risk of coronary heart disease or mortality from cardiovascular disease in women without prior history. NICE NG23
Potential increased risks include a possible increase in dementia risk if HRT is started at age 65 or over. NICE NG23
Other risks include the potential for vaginal bleeding, especially within the first 3 months of systemic HRT, which should be monitored. NICE NG23
Women with certain conditions, such as a history of thromboembolic events or active liver disease, should also be considered contraindicated for HRT. NICE CKS