According to current guidelines, hormone therapy is generally considered safe for healthy women who are within 10 years of menopause or younger than 60. These women should be experiencing significant menopause symptoms that impact their quality of life. The therapy should be used at the lowest effective dose for the shortest time needed to relieve symptoms. Women without a uterus can use estrogen alone, while those with a uterus need combined estrogen-progestin therapy.

Certain women should not use hormone therapy due to increased health risks. This includes women with a history of breast cancer, coronary heart disease, previous blood clots or stroke, or active liver disease. Women who are more than 10 years past menopause or older than 60 should generally avoid starting hormone therapy, as the risks may outweigh the benefits. Long-term use for disease prevention is not currently recommended for any group.

Some groups require careful consideration. Women with a family history of breast cancer should discuss their individual risk factors with their doctor. Those who have had their ovaries removed before age 45 (primary ovarian insufficiency) may have different considerations and potential benefits from hormone therapy. For BRCA1/2 gene carriers who've had risk-reducing surgery, the decision requires careful discussion of risks and benefits.

Hormone therapy can be beneficial for some women, but it's crucial to make an informed decision based on individual health factors and current guidelines.