Hormone Replacement Therapy and Stroke Risk

What are the effects of hormone replacement therapy on a person who has a history of lacunar stroke?

Hormone replacement therapy (HRT) has been shown to increase the risk of ischemic stroke (lacunar stroke is a subtype of ischemic stroke).

Although the absolute risk of complications such as stroke is relatively low in young, healthy women who use HRT for short periods of time (less than five years), it is generally recommended that women who have had a stroke avoid HRT.

There may be some evidence that locally applied estrogen (such as creams, as opposed to the pill form) might be safer in these women.