Thromboembolic and Cardiovascular Safety of Menopausal Hormone Therapy

Most of what we know about the thromboembolic and cardiovascular safety of menopausal hormone therapy (MHT) comes from older studies in which women mostly received oral conjugated equine estrogens. To estimate risks associated with contemporary estradiol-based regimens, researchers identified 40,000 women in Denmark aged 50 to 69 with a first diagnosis of venous thromboembolism (VTE), ischemic stroke, or myocardial infarction (MI), assessed their current MHT usage (at time of diagnosis), and compared it with MHT usage in age-matched controls.

Among current MHT users, 88% used oral estrogen (nearly all oral estradiol) and 73% used combination estrogen–progestin, most often with norethisterone acetate.