HRT Risk Profile

What the HRT Risk Profile does

The HRT Risk Profile is a rule-based questionnaire that maps a few facts about you onto four separate categories of hormone-therapy risk: cardiovascular, clotting (VTE), cancer, and metabolic. You enter your age, how many years it has been since menopause, and your BMI, then tick any of six history flags that apply: personal breast cancer, family breast cancer, a prior blood clot, established cardiovascular disease, current smoking, and hypertension. It returns one plain-language finding per category, labeled low, moderate, high, or contraindicated.

It is a fixed decision tree, not a statistical model. There is no algorithm learning from data, no percentage score, and nothing is sent anywhere or saved. The same inputs always produce the same four findings because each category runs through a short list of if-then rules written into the page. For example, ticking 'prior blood clot' marks clotting risk as contraindicated for oral estrogen every time, and being 60 or older (or more than 10 years past menopause) flips cardiovascular risk from low to moderate.

The point is to help you walk into an appointment already knowing which of your specific factors a prescriber is likely to weigh, and in which direction. It sorts the questions that matter for hormone therapy from the ones that do not, so the conversation with a clinician starts further along.

How to read your result

Read each of the four findings on its own — they are independent, and the tool never combines them into a single overall verdict. You can land on 'low' for cardiovascular risk and 'contraindicated' for clotting at the same time; that is by design, because those risks are driven by different factors. A 'contraindicated' label points to something that usually rules out one form of hormone therapy (systemic or oral estrogen), not necessarily every option — the clotting finding, for instance, still notes that transdermal routes may be discussed with a specialist.

Treat the wording as a prompt for questions, not an answer. The tool applies thresholds a clinician would recognize (the NAMS standard initiation window it references is starting hormone therapy under age 60 and within 10 years of menopause), but it cannot see your labs, your symptom burden, your other medications, or the tradeoff between your risk and how much menopause is affecting your life. Bring the four findings to a menopause-literate prescriber and use them to ask why a given route or formulation is or is not on the table for you.

What the result is based on

Every result comes from the fixed rules coded into the tool, applied only to what you type in. Cardiovascular risk keys off established heart disease first, then off age 60+ or more than 10 years since menopause. Clotting risk keys off a prior VTE, then off smoking combined with age 35+, then off a BMI of 30 or higher. Cancer risk keys off personal then family breast-cancer history. Metabolic risk keys off a BMI of 30 with hypertension, then off a BMI of 25 or higher.

These thresholds reflect commonly cited menopause-care checkpoints — age and years-since-menopause for the initiation window, VTE and smoking history for route selection, breast-cancer history for whether systemic hormones are appropriate. The tool states these as its own working assumptions. It does not run against any external dataset, guideline database, or your medical record, and it produces no probability or numeric score.

What it cannot tell you

• It only knows the nine inputs on the page. It cannot account for the type of hormone therapy (estrogen alone vs. estrogen plus a progestogen), the dose, or the delivery route beyond the general oral-vs-transdermal note it prints.
• It has no view of your labs, blood pressure readings, current medications, or bleeding history, so it cannot flag drug interactions or contraindications that come from anywhere other than the six checkboxes.
• Each category returns exactly one finding based on the first rule that matches, so it does not stack or weight multiple risk factors within a category — a smoker with obesity and a prior clot still shows a single clotting message, not a combined picture.
• Its cutoffs are hard edges: a BMI of 29.9 and 30.0, or an age of 59 and 60, can land in different buckets even though real risk changes gradually, not at a line.
• It does not weigh symptom severity or quality of life against risk — a high-risk label says nothing about whether the benefit might still be worth it for you.
• It cannot diagnose menopause, confirm any condition, prescribe, or recommend a specific product; every output is educational and belongs in a conversation with a qualified prescriber.