Hormone replacement therapy (female)
What the FAA's documents say about hormone replacement therapy (female), in plain words, with the FAA's own words one press away.
FAA term: Hormone Replacement Therapy (HRT) - FemaleCovers: All classes
Show the FAA's words: which classes the FAA's table covers
HORMONE REPLACEMENT THERAPY (HRT) - Female All Classes
- For a history of VTE or stroke, the table's Row B says to see that page, without naming it. Crosscheck has a page on VTE (blood clots), written from the FAA's protocol for thromboembolic disease and its AASI.
- For a history of VTE or stroke, the table's Row B says to see that page, without naming it. Crosscheck has a page on stroke and TIA, written from the FAA's disposition table and AASI for them.
Low testosterone (hypogonadism)
Row A's examples of hormone replacement include testosterone. The FAA also publishes a disposition table for Low Testosterone (Low T) Hypogonadism, and Crosscheck has a page on it.
Short version
The disposition table has two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AHormone replacement near physiologic levels | Examiner issues | Examiner can issue |
| Row BAll others | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Hormone replacement therapy (female)
- Row A · Examiner can issue
Hormone replacement (for example estrogen, progesterone, or testosterone) near physiologic levels. The row's note says that if the examiner determines the individual is at increased risk for VTE (for example, a hypercoagulable condition), go to row B. If the examiner can determine there are no side effects which would interfere with flight duties, no history of VTE (PE/DVT), and no history or increased risk of stroke, severe migraine, or uncontrolled HTN, the table says ISSUE, and the examiner summarizes in Item 60.
A. Hormone replacement (e.g. estrogen, progesterone, or testosterone) near physiologic levels … If the AME can determine there are • no side effects which would interfere with flight duties, • no history of VTE (PE/DVT) • no history or increased risk of stroke, severe migraine, or uncontrolled HTN Note: if the AME determines the individual is at increased risk for VTE (e.g. hypercoagulable condition), go to row B. … ISSUE Summarize in Item 60.
- Row B · Special Issuance
All others. For a history of VTE or stroke, the row says see that page, without naming it. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes elements or findings in Item 60.
B. All others If history of VTE or stroke, see that page … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
The FAA pathways for hormone replacement therapy (female)
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: what the examiner determines
Hormone replacement near physiologic levels.For Row A, your AME determines the three things the table lists. If your AME can determine them, the table says ISSUE.
If the AME can determine there are
- No side effects which would interfere with flight duties
- No history of VTE (PE/DVT)
- No history or increased risk of stroke, severe migraine, or uncontrolled HTN
At the exam
- Your AME summarizes in Item 60
Show the FAA's words: Row A: what the examiner determines
If the AME can determine there are • no side effects which would interfere with flight duties, • no history of VTE (PE/DVT) • no history or increased risk of stroke, severe migraine, or uncontrolled HTN
ISSUE
FAA source: Hormone Replacement Therapy (HRT) - Female. FAA date 29 April 2026; checked by Crosscheck 14 October 2026.
ISSUE Summarize in Item 60.
FAA source: Hormone Replacement Therapy (HRT) - Female. FAA date 29 April 2026; checked by Crosscheck 14 October 2026.
Note: if the AME determines the individual is at increased risk for VTE (e.g. hypercoagulable condition), go to row B.
FAA source: Hormone Replacement Therapy (HRT) - Female. FAA date 29 April 2026; checked by Crosscheck 14 October 2026.
Step 2: See your AME
If the examiner can determine there are no side effects which would interfere with flight duties, no history of VTE (PE/DVT), and no history or increased risk of stroke, severe migraine, or uncontrolled HTN, the table says ISSUE, and the examiner summarizes in Item 60.Exam day- If the examiner can determine there are no side effects which would interfere with flight duties, no history of VTE (PE/DVT), and no history or increased risk of stroke, severe migraine, or uncontrolled HTN, the table says ISSUE, and the examiner summarizes in Item 60.
Show the FAA's words: See your AME
A. Hormone replacement (e.g. estrogen, progesterone, or testosterone) near physiologic levels
If the AME can determine there are • no side effects which would interfere with flight duties, • no history of VTE (PE/DVT) • no history or increased risk of stroke, severe migraine, or uncontrolled HTN Note: if the AME determines the individual is at increased risk for VTE (e.g. hypercoagulable condition), go to row B.
ISSUE Summarize in Item 60.
FAA source: Hormone Replacement Therapy (HRT) - Female. FAA date 29 April 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
If the examiner can determine there are no side effects which would interfere with flight duties, no history of VTE (PE/DVT), and no history or increased risk of stroke, severe migraine, or uncontrolled HTN, the table says ISSUE, and the examiner summarizes in Item 60.
Row BDefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes elements or findings in Item 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Hormone replacement (for example estrogen, progesterone, or testosterone) near physiologic levels. The row's note says that if the examiner determines the individual is at increased risk for VTE (for example, a hypercoagulable condition), go to row B. If the examiner can determine there are no side effects which would interfere with flight duties, no history of VTE (PE/DVT), and no history or increased risk of stroke, severe migraine, or uncontrolled HTN, the table says ISSUE, and the examiner summarizes in Item 60.
A. Hormone replacement (e.g. estrogen, progesterone, or testosterone) near physiologic levels … If the AME can determine there are • no side effects which would interfere with flight duties, • no history of VTE (PE/DVT) • no history or increased risk of stroke, severe migraine, or uncontrolled HTN Note: if the AME determines the individual is at increased risk for VTE (e.g. hypercoagulable condition), go to row B. … ISSUE Summarize in Item 60.
- Row B · Special Issuance
All others. For a history of VTE or stroke, the row says see that page, without naming it. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes elements or findings in Item 60.
B. All others If history of VTE or stroke, see that page … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize elements or findings in Item 60.
If the examiner defersSpecial Issuance
The table marks Row B, all others, DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note from a clinic visit with the treating physician no more than 90 days prior to the exam.
- Item 2. The table's second item, which reads that it must specifically include if any history of a hypercoagulable condition, and of VTE (PE/DVT) or stroke. The item does not say what "it" refers to.
- Item 3. Labs or imaging already performed or determined necessary by the treating provider.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, all others, DEFER.
B. All others If history of VTE or stroke, see that page … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current, detailed clinical progress note from a clinic visit with the treating physician no more than 90 days prior to the exam.
1. A current, detailed Clinical Progress Note generated from a clinic visit with the treating physician no more than 90 days prior to the AME exam.
- Item 2
The table's second item, which reads that it must specifically include if any history of a hypercoagulable condition, and of VTE (PE/DVT) or stroke. The item does not say what "it" refers to.
2. It must specifically include if any history of: o Hypercoagulable condition o VTE (PE/DVT) or stroke.
- Item 3
Labs or imaging already performed or determined necessary by the treating provider.
3. Labs or imaging already performed or determined necessary by the treating provider.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Increased risk for VTE goes to row B
Row A's note says that if the examiner determines the individual is at increased risk for VTE (for example, a hypercoagulable condition), go to row B. The table marks Row B DEFER.
Show the FAA's words: good to know, 2
Note: if the AME determines the individual is at increased risk for VTE (e.g. hypercoagulable condition), go to row B. … DEFER Submit the information to the FAA for a possible Special Issuance.
A history of VTE or stroke, and that page
Row A's ISSUE rests on no history of VTE (PE/DVT) and no history or increased risk of stroke. Row B says that for a history of VTE or stroke, see that page, without naming it, and the same row lists what to submit for FAA review. This page shows both as printed.
Show the FAA's words: good to know, 3
• no history of VTE (PE/DVT) • no history or increased risk of stroke, severe migraine, or uncontrolled HTN … B. All others If history of VTE or stroke, see that page … Submit the following for FAA review:
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.