Which of the following conditions is a contraindication for hormone replacement therapy in menopausal women?

Hormone replacement therapy (HRT) can pose significant risks in certain medical scenarios, making it crucial to identify contraindications before initiation.

A history of breast cancer is a well-established contraindication for HRT due to the increased risk of cancer recurrence from exposure to estrogen and, in some cases, progesterone. The hormones can promote the growth of hormone-sensitive tumors.

Unexplained vaginal bleeding is also a contraindication because it may signify an underlying condition, such as endometrial hyperplasia or cancer, that warrants further evaluation before considering HRT. It is essential to determine the cause of the bleeding to avoid exacerbating any existing pathology.

Active liver disease presents another clear contraindication to HRT. The liver plays a vital role in the metabolism of hormones, and in the presence of liver dysfunction, the risks of hormone therapy are elevated, including potential for increased complications and altered hormone clearance, which can lead to adverse effects.

Given these points, all the mentioned conditions—history of breast cancer, unexplained vaginal bleeding, and active liver disease—are indeed contraindications for hormone replacement therapy in menopausal women. Thus, recommending HRT in any of these situations could pose serious health risks, solidifying the correctness of the answer that all of the