Can you take HRT if you smoke?

Taking hormone replacement therapy (HRT) can have risks, especially for those who smoke. When considering HRT, it's important to weigh the potential benefits against the potential risks with your healthcare provider.
Some key points about smoking and taking HRT:

• Cigarette smoking, no matter how much or little, increases the risks associated with taking HRT. Smokers are more likely to experience strokes, blood clots, heart attacks, and breast cancer compared to non-smokers on HRT.


• If you smoke, your doctor may recommend not taking HRT, or may prescribe a lower dose estrogen patch or vaginal estrogen which have less risk than oral estrogen.


• If you do take HRT, you will need to be monitored more closely than non-smokers on HRT. Frequent check-ups and testing are necessary.


• Quitting smoking, even if you've smoked for years, can significantly lower your risks. Former smokers have lower risks than current smokers.

Benefits of HRT

HRT can provide relief from menopausal symptoms like:

• Hot flashes


• Night sweats


• Vaginal dryness


• Mood changes


• Sleep disturbances

It can also prevent bone loss and reduce fracture risk.

However, the risks are higher if you smoke, so you'll need to determine if HRT is right for you by discussing options with your doctor.

Risks and side effects

HRT does come with some general risks and side effects:

• Blood clots


• Stroke


• Heart attack


• Breast cancer


• Gallstones


• Urinary incontinence

These risks are higher in women over age 60 in general, and smoking amplifies them across all ages.

Options if you smoke

• If you smoke and want to take HRT, some lower risk options may include:
  
  
  • Lower dose estrogen skin patches or creams
  
  
  • Vaginal estrogen inserts - for vaginal dryness only
  
  
  • Progestin-only HRT
  
  


• Your doctor can help determine if one of those options would be suitable for you and your menopause symptoms.


• More frequent follow-up and testing would be necessary to closely monitor you for side effects.

Quitting smoking

• If you quit smoking, even after heavy long-term smoking, your health risks will drop significantly within:
  
  
  • 2-5 years - risk of stroke drops to a non-smoker's risk
  
  
  • 5-10 years - risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decreases
  
  
  • 10 years - risk of death from lung cancer drops by half
  
  
  • 15 years - risk of heart disease is similar to someone who has never smoked
  
  


• Quitting smoking lets you reap all the health benefits, and can allow you to take HRT more safely if needed. Talk to your doctor about smoking cessation options.


• Resources to help you quit:
  
  
  • (/tobacco/quit_smoking/)
  
  
  • Toll-free hotline - 1-800-QUIT-NOW
  
  

In summary

• Smokers considering HRT should carefully weigh risks and benefits with their healthcare providers.


• Lower dose patches or vaginal estrogen may be options for symptom relief.


• More monitoring will be necessary throughout HRT treatment if you smoke.


• Quitting smoking, even after long-term use, can significantly improve your health and reduce risks from HRT. Consult your doctor about nicotine replacement or prescription medications to help you quit.

At Butterfly Hormone Center, we specialize in customized bioidentical hormone therapy to help women relieve menopause symptoms. Contact us today to ask about our quit smoking program and to discuss your hormone therapy options.