Smoking is not a contraindication to using HRT, but we strongly recommend that you stop smoking to significantly improve your overall health.
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It often causes confusion that smokers can safely take hormone replacement, 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.
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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, which further decreases the risks associated with estrogen and smoking. Choosing a transdermal option for administering HRT (creams and patches) decreases the risk even further.