Some individuals in surgical menopause have a personal or family history of conditions that can be affected by hormones, and thus are more concerned about HRT risks.
In surgical menopause, there is no evidence that using estrogen increases risk of cancer, blood clot, or stroke. Large studies of estrogen in surgical menopause completed in both America and Denmark have demonstrated that long-term estrogen in surgical menopause (e.g., 5+ years) may actually reduce risk for cardiovascular disease and breast cancer, and does not appear to alter risk of blood clots or stroke.
In the case of breast cancer, studies suggest that estrogen does not increase risk of breast cancer when used in surgical menopause, even among those who are BRCA1 or BRCA2 carriers (familial risk for breast cancer). Nevertheless, if you are concerned about using estrogen due to a family history of estrogen-dependent cancers or blood clots, it is wise to discuss this with your doctor to make sure that you are carefully dosed and monitored to avoid adverse effects of estrogen. Alternative medications can also be used in some cases.
Visit www.iapmd.org/surgery for lots of evidence-based information and resources for those considering, going through or recovering from surgery for PMDD/PME.