At this point, it should go without saying that smoking is bad for your health, and we strongly recommend that you quit smoking to significantly improve your overall health.
That being said, smoking is not a contraindication to using HRT. Smokers can safely take hormone replacement. This often causes confusion, because combination birth control pills are contraindicated for smokers over 35 years old. The difference has to do with the types of hormones used and the relative dose of the hormones.
The hormones Winona uses for HRT are bioidentical and are found to have fewer side effects and risks than the synthetic hormones in birth control pills. Additionally, the dose of the hormones in HRT is much smaller than even the lowest-dose birth control pill, further decreasing the risks associated with estrogen and smoking. The transdermal options for administering HRT (creams and patches) decrease the risk even further.