To assess your breast cancer risk:
If over 5%, you are contraindicated to use hormone therapy. I would add here, that if you have dense breasts, particularly if you are a large cup size, there are studies indicating you are at higher risk for breast cancer (makes sense. more breast tissue = more cells that can go wayward). See study on breast density HERE>
Breast Cancer Risk Assessment Tool
To assess your heart risk:
One of the biggest reasons cited to do hormone replacement therapy is to help heart health. The studies show starting hormones later (ie age 60) is not helpful, and may actually harm you. If you are going to do it, you should start it in the menopause change window. In this assessment: If over 10%, you are contraindicated to use hormone therapy
ASCVD Risk Estimator + (acc.org)
To assess blood clot risk:
Read my blogs on Caprini score HERE. Blood clots are a huge worry for us as surgeons, so we think about it all the time. We do a blood clot risk assessment on all surgical patients. In general, your risk for blood clots increases as you age. Did your mom have a DVT? Did you have one in pregnancy? Anyone a Leiden carrier? Is your BMI higher? Do you take hormone replacement in any form? (IUD, birth control, hormone replacement). Do you have varicose veins?
If you are at higher risk for a blood clot, it is something to factor in, as estrogen is known to increase the rate of blood clots. It was interesting in my review of all this data that it seems the estrogen patch (transdermal) reportedly “does not increase clot risk,” and in the vaginal estrogen applications, especially at the low doses (4mcg or 10mcg), there was very little absorption into the blood stream, particularly when the vaginal wall thickened after some use.