Dr. Evans shares what a woman taking hormone replacement therapy (HRT) should know about her risk for strokes.
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This is one I have very personally dealt with because my mom came to me with the exact same question. It is absolutely true. There are large studies of women taking hormone replacement or HRT therapy after menopause and they do suggest that women have an excess risk of stroke if they take those medications. It’s a relatively small excess risk. Over a group of 10,000 women–if 10,000 women didn’t take the therapy and another 10,000 women did take the hormone replacement therapy, the group that took the therapy would have about seven extra strokes over a four or five year period of time, and so it’s a fairly small increase, but it is there, and the counseling that I usually have with women who ask me about it is that it’s an individual question. If the hormone therapy were something that they never really thought they needed, they didn’t really have particularly strong menopausal symptoms or it’s been a while since they went through menopause, then it’s very reasonable to try coming off the hormone therapy and see how they feel, and if they can feel good and have good control of their lives without the hormone therapy, there’s really no reason they need to be on it, and they reduce their stroke risk by getting off of it. On the other hand, for the woman who has persistent and disabling and really unpleasant hot flashes or vaginal irritation and discomfort, the risk is really probably pretty small and probably doesn’t outweigh the benefit to her life that she actually gets from the therapy, and so like a lot of things in medicine, it’s really something that’s individual and they need to talk to their doctor about so they can have the best decision for them.

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