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What are the side effects of hormone therapy for menopause?

Donna Hill Howes, RN
Family Practitioner

Side effects may include headaches, nausea, breast tenderness, blotchy discolored skin, weight changes, or depression. Other side effects may include fluid retention (holding water), enlarged uterine fibroids, abnormal uterine bleeding, and high triglyceride levels. Hormone therapy that contains drospirenone has been linked to a high potassium in the blood.

Hormone therapy has also been linked to heart disease, such as heart attacks, strokes, and blood clots that block veins. The risk is higher for women who start hormone treatment more than 10 years after menopause or after age 59. The risks depend partly on your overall heart health.

Women who take hormone therapy that contains estrogen and progestin for more than 3 to 5 years have higher rates of breast cancer. But the risk is small, and drops after you stop hormone treatment. Estrogen therapy is not recommended for women who have had breast cancer. 

The rate of ovarian cancer is slightly higher than average for women who have taken hormone therapy, even if it was for less than 5 years. The risk is about the same for estrogen-only therapy and estrogen therapy with progestin. The risk slowly drops after you stop hormone therapy.

The hormones estrogen and progestin raise the level of cholesterol in your gallbladder. This can lead to gallstones.

Many women have mood problems and depression around menopause. Women who take estrogen for other menopause symptoms, such as hot flashes, often have better moods. But antidepressant medications are still the first choice for treating serious depression.

For many women, hot flashes are worst during the first 2 years after menopause, and then go away naturally over time. But some women have hot flashes for 10 years or longer. Hot flashes often come back when you stop hormone therapy.

Due to the health risks of hormone therapy, experts recommend using it at the lowest effective dose for the shortest amount of time needed to relieve your symptoms. Most women use it for less than 3 years.

This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.