Menopausal Hormone Therapy and Risk for Venous Thromboembolism: Route of Administration Matters

Case-control study of two large U.K. databases indicates that transdermal estrogen is safer than oral.

The Women's Health Initiative, which randomized menopausal women to oral conjugated equine estrogen (CEE) or placebo, found that excess risk for venous thromboembolism (VTE) was statistically the biggest risk associated with menopausal hormone therapy (HT). Now, using two U.K. primary care databases, investigators identified some 80,000 women (age range, 40–79) with VTE diagnosed from 1998 to 2017 and 390,000 control women matched by age and practice. Mean overall age was 64; most participants were white. Analyses were adjusted for smoking, body-mass index, family history of VTE, and comorbidities associated with VTE.

Compared with no HT, use of oral CEE (odds ratio, 1.49) or estradiol (OR, 1.27) was associated with elevated risk for VTE (P<…

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Menopausal Hormone Therapy and Risk for Venous Thromboembolism: Route of Administration Matters

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Reviewing Author