Menopause news

HRT and the risk of venous thromboembolism: population-based study

24 March 2010

A study reported this month in the Journal of Thrombosis and Haemostasis has shed more light on the issue of HRT and risk of blood clot.

British women aged 50 to 79 were followed up between January 1987 and March 2008 and women who experienced venous thromboembolism (VTE) were identified. The rate of VTE in users of different types of HRT compared to non-HRT users was estimated. Of the 955 582 postmenopausal women there were 23 505 cases of VTE matched to 231 562 controls. The risk of VTE was not increased with current use of transdermal (patch or gel) oestrogen alone or combined with a progestogen neither with current use of tibolone relative to non use. On the other hand, the risk was increased with current use of oral (tablet form) oestrogen and oral oestrogen-progestogen, and increased with an increasing dose of oestrogen. The risks with oral formulations were particularly elevated during the first year of use but disappeared four months after discontinuation.

Conclusion: Transdermal HRT and tibolone were not associated with an increased risk of VTE in postmenopausal women.

Comments
It has been known for some time that tablet form of HRT is associated with a small risk of VTE, mostly within the first year of use, and is most relevant to women who have other risk factors for VTE such as past history of VTE, family history or immobility. If there are no such risk factors, then tablet form is still a very useful therapy with minimal risk but for those concerned about this risk, or with other risk factors, this study provides further reassurance that both transdermal therapy and tibolone do not seem to carry an increased risk.

Reference [58]

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