Oral hormone replacement therapy increases blood clot risk
Oral hormone replacement therapy (HRT) may increase a woman’s risk of experiencing a serious blood clot, according to new findings published in The BMJ.[1] High-doses of oral HRT were linked to additional risks that may influence treatment decisions.
Researchers identified nearly 10,000 women who received a first diagnosis of venous thromboembolism, more than 18,000 women who received a first diagnosis of heart attack and nearly 12,000 women who received a first diagnosis of ischemic stroke from 2003 to 2021.All patients lived in Denmark at the time of their diagnoses. These women were then matched with large cohorts of women with no such diagnoses, and prescription records were evaluated to track the use of HRT. Patients with a history of blood clots, cancer, surgery or a handful of other health conditions were excluded from the team’s analysis.
Overall, oral HRT was consistently linked to an increased risk of venous thromboembolism. High-dose oral HRT—defined as anything more than 1 mg per day—was linked to a slightly higher risk of experiencing a heart attack or ischemic stroke if therapy lasts more than one year.
Transdermal HRT, the group added, was not linked to any of these various cardiovascular concerns.
The group did note that there were certain limitations to this research. It is an observational analysis, for example, and data on smoking status and other patient details were not available. Even with these things in mind, however, these findings may be something for care teams to consider when making treatment decisions.
“The findings from this study, together with earlier evidence, indicate that the thrombotic risk associated with contemporary systemic menopausal hormone therapy is influenced by the method of use, the daily estrogen dose, and treatment duration,” wrote first author Julie Berggreen, a researcher with Steno Diabetes Center Copenhagen, and colleagues. “These insights may inform clinical practice, guiding clinicians and patients in making evidence based decisions to minimize thrombotic risk of hormone therapy. Future research should further explore the long term cardiovascular risks associated with different treatment regimens and the influence of individual cardiovascular risk profiles including age at menopause onset.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.