Question 193 of 433
What are the real risks?
The short answer
A small increase in breast cancer risk with long-term combined therapy, and a small risk of blood clots and stroke with estrogen taken as a pill.
Estrogen delivered through the skin by patch, gel, or spray does not appear to raise clot risk the way pills do, which is why many cardiologists prefer it. Women who still have a uterus need a progestogen as well, to protect the lining. Estrogen alone, in women who have had a hysterectomy, did not raise breast cancer risk in the long-term data and may have lowered it.
Hormone therapy is generally not advised after breast cancer, a prior clot or stroke, or active liver disease.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
HUMAN TRIALS / OBSERVATIONAL — Menopausal therapy risks; transdermal clot comparisons are largely observational.Evidence grade (draft mapping)CObservationalPart 14, Q193 · Sources: R6
Sources cited
- R6 US Food and Drug Administration. FDA Approves Labeling Changes to Menopausal Hormone Therapy Products. February 12, 2026. Link pending verification
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.