Contraindication – When should hormone replacement therapy not be used?
Some diseases directly rule out treatment with estrogens. These include breast cancer and uterine cancer, where the hormones can lead to increased tumor growth. Coagulation disorders and thromboses are also an exclusion criterion, as the hormones increase the risk of thrombosis. If there is bleeding from the vagina, the cause of the bleeding must first be determined before hormone therapy can be started. In some liver diseases it may also be the case that no hormone replacement therapy can be given.
How long can hormone replacement therapy be given?
Hormone replacement therapy means a serious intervention in some bodily functions. The duration of the therapy should be kept as short as possible, since the risk of side effects increases with both the duration of the intake and the age of the woman. If the therapy lasts longer than five years, some of the risks remain increased even after discontinuation.
Hormone replacement therapy should only be used for as long as medically necessary, as the likelihood of side effects increases with the duration of use. After about two years the first attempt to discontinue the therapy can be started. This should be discontinued over a period of several months.
This means that the dosage is first reduced. This is lowered more and more and can be increased again if the symptoms flare up again. In this way, the woman’s body can adapt to the falling hormone levels.
Some women no longer experience any symptoms because the therapy can bridge the difficult phase, but some women also report that the therapy has only shifted the problems to the back of the head.The exact effects of hormone therapy after discontinuation are not yet fully understood. However, studies have already shown that the risk of developing breast cancer is higher after the end of a five-year therapy than in women without hormone replacement therapy. Especially older women should therefore think about discontinuing their medication as early as possible.
