Which is a contraindication for MHT?

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MHT is avoided when there are conditions that would make estrogen-containing therapy risky. A history of breast cancer is a contraindication because many breast cancers are hormone sensitive and can be stimulated by estrogen. Introducing estrogen (with or without a progestin) could potentially promote the growth of residual cancer cells or lead to recurrence, so MHT is not used in women with a personal history of breast cancer. Other scenarios listed—being healthy without risk, regular exercise, or normal fertility—do not by themselves create a safety concern for MHT and are not reasons to withhold therapy based on this principle; they don’t indicate an increased risk from the therapy in the same way a prior breast cancer does. If symptoms remain challenging for someone with a history of breast cancer, non-hormonal options and close collaboration with a clinician are typically pursued.