Is there a safe estrogen therapy if I have had a tia ?

Catherine,

The medical answer may depend on your age and your other risk factors for stroke. A TIA (transient ischemic attack) is a mini-stroke, and estrogen therapy and strokes are strongly linked. According to one doctor, estrogen therapy doubles the risk of blood clots, which can lead to stroke, so you're right to be seeking serious answers to this question. From a purely woman-to-woman point of view, I'd like to know why you want estrogen therapy? Is it for hot flashes? I'd encourage you to think twice about estrogen therapy if it is "just" for hot flashes. While terribly annoying, they last maybe 5 years and I know that is along time, but a stroke lasts forever. And hot flashes can be "cooled" in other ways, including meditation, which lowers stress hormones. Soy foods and some herbals help some women. Since you've already had a mini-stroke, any medical professional will want you to think twice about estrogen, so listen to the advice he or she gives to you.

Good luck,

Toni

Hi Catherine,  Unfortunately, I have to tell you that the answer is probably no.  What the research (the HERS study, in particular) shows is that women with any cardiac history should not be prescribed estrogen therapy.  If you had already been on estrogen for more than a year before your TIA, then there would be no reason to take you off.  However, there is an increased risk of cardiac events for you in the first year of therapy.  It goes down after that, but -since I'm assuming-- you've not been on it, I would recommend you not start.

Depending on your symptoms, there are some alternative therapies that might be very helpful in making this a more comfortable period of change for you.  If your own provider is not a menopause expert, seek out someone in your area who is, so you get the best help available.

Good luck to you, Sandy.