Noncancerous Conditions in the Uterus Women with a recent history of endometriosis may be advised not to take estrogen replacement therapy for several months after menopause because it might reactivate the condition and cause pain. Postmenopausal women who have a history of submucous fibroids and abnormally heavy bleeding may find that when they start hormone replacement therapy the heavy bleeding recurs, although some studies have found that standard HRT doses do not increase the risk for recurring fibroids in most postmenopausal women. Gallstones Estrogen stimulates the liver to remove cholesterol from blood and divert it into the biliary tract and gallbladder. If too much cholesterol is dumped by the liver into the gallbladder, it may precipitate out of the bile solution and form gallstones. As a result, postmenopausal women taking high doses of estrogen face an increased risk for gallstones.
Low doses pose no problem.
In any case, gallstones are very common in all older American women and are rarely problematic. It should be noted, however, the risk for this condition is still extremely low. Only women with a previous history of thromboembolism or other risk factors for it should avoid HRT for this reason. Some women taking oral contraceptives are at risk for high blood pressure, although this is very unlikely in postmenopausal estrogen therapy. In fact, according to a recent Dutch study, HRT may actually lower blood pressure in women with normal pressure.