Prescribing Safety Assessment (PSA) Practice Exam

What is the timing for stopping HRT prior to surgical procedures?

1. The day before

2. 4 weeks before

3. 1 week before

4. No need to stop

The correct answer is: 4 weeks before

The timing for stopping hormone replacement therapy (HRT) prior to surgical procedures is generally advised to be 4 weeks before the surgery. This recommendation is largely based on concerns regarding thromboembolic events, particularly in patients who may be at increased risk due to the use of estrogen-containing therapies. Discontinuing HRT at least 4 weeks before surgery helps to minimize such risks and allows for a reduction in estrogen levels, which is especially important for surgeries associated with a higher likelihood of thrombosis. Stopping HRT a shorter time frame – such as the day before or one week prior – does not provide sufficient time for the body to adjust, potentially maintaining elevated thrombotic risk. Conversely, not stopping HRT at all could lead to unnecessary complications during and after surgery, particularly in those with other risk factors. Therefore, the recommendation to cease HRT for 4 weeks prior to a surgical procedure is based on evidence aimed at improving patient safety.