Quitting Hormone Replacement Therapy for Menopause

By Camille Peri WebMD Feature

Is there a right time to stop using hormone replacement therapy (HRT) to relieve menopause symptoms? Are there risks to staying on hormones or to quitting them? What can you expect if you quit?

If you are healthy, most experts agree that HRT is safe to use at the lowest dose that helps for the shortest time needed. If you're 59 or older, or have been on hormones for 10 years, you should talk to your doctor about whether it's time to quit. Here are some things to consider when you decide.

A large study called the Women's Health Initiative showed that women who took estrogen and progestin were more likely to have illnesses such as heart disease, breast cancer, stroke, and blood clots than women who didn't.

Some women in the study took estrogen only because they had had hysterectomies to remove their uterus. They had a slightly higher chance of stroke and blood clots, but not breast cancer or heart disease.

The risks depend on your age when you started hormones and how long you've taken them.

There is no set time a woman should be on HRT. "We ask a woman to go off hormones at 5 years," says Anne W. Chang, MD, of the University of California at San Francisco. "We talk about the reasons why she should go off. But it's a shared decision."

"Being on hormones longer doesn't raise your risk for blood clots, but age does," Chang says.

Isaac Schiff, MD, of Massachusetts General Hospital in Boston, goes over the pros and cons of quitting of hormone therapy with his patients every year. He says he puts the cons, like breast cancer risk, in perspective.

"If you aren't on hormones, your risk of breast cancer is 3 out of 1,200 per year," Schiff says. "If you're on hormones, it's 4 out of 1,200." Some women are comfortable staying on hormones with that risk. "It's a very individual decision," he says.

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Quitting Hormone Replacement Therapy for Menopause