Hormone Therapy Contraindications

Absolute Contraindications

The American College of Obstetricians and Gynecologists recommends that hormone therapy is absolutely contraindicated in women with known or suspected breast cancer, estrogen-dependent neoplasia (such as low-grade serous ovarian cancer, granulosa cell tumors, leiomyosarcoma, stromal sarcoma, and advanced endometrioid uterine adenocarcinoma), a history of venous thromboembolism or stroke, and antiphospholipid syndrome 1
Estrogen-dependent neoplasias, including low-grade serous ovarian cancer, granulosa cell tumors, leiomyosarcoma, stromal sarcoma, and advanced endometrioid uterine adenocarcinoma, are absolute contraindications for hormone therapy, as stated by the National Comprehensive Cancer Network 2, 1
A history of thromboembolic events, such as venous thromboembolism or stroke, is an absolute contraindication for hormone therapy, according to the American Heart Association 1
Active liver disease is an absolute contraindication for hormone therapy, as recommended by the American Association for the Study of Liver Diseases 3

The European Society of Gynecological Oncology states that there is no contraindication for hormone therapy in women with cervical, vaginal, or vulvar cancer, as these tumors are not hormone-dependent 2
The National Comprehensive Cancer Network recommends that hormone therapy may be considered for women with non-epithelial ovarian cancer, high-grade epithelial ovarian cancer, and early-stage endometrial cancer, as the risk-benefit profile is favorable 2
The American College of Obstetricians and Gynecologists recommends that hormone therapy is contraindicated in women with a history of breast cancer, except for those with a high risk of ovarian cancer who have undergone prophylactic oophorectomy 4

The American Heart Association states that women aged 60 years or more, or more than 10 years post-menopause, have an increased risk of stroke with oral estrogen-containing hormone therapy 1, 3
The European Society of Cardiology recommends that women with established cardiovascular disease, such as a history of myocardial infarction, have a relative contraindication to hormone therapy 1

The American College of Obstetricians and Gynecologists recommends that a systematic evaluation of breast cancer history, liver disease, myocardial infarction, estrogen-dependent neoplasia, deep vein thrombosis, and thrombophilic disorders be performed before initiating hormone therapy 1