Hormonal
Current use of oral estrogen increases the risk of venous thromboembolism in postmenopausal women, with the highest risk occurring during the first year of treatment.
If you are a postmenopausal woman considering hormone replacement therapy, be aware that taking estrogen orally increases your risk of blood clots (venous thromboembolism), especially during the first year of use. This risk is roughly 2.5 times higher than in non-users. However, using estrogen through the skin (transdermal patches/gels) does not appear to increase this clotting risk, making it a potentially safer option to discuss with your doctor.
Meta-analysis of observational studies showed that oral oestrogen but not transdermal oestrogen increased the risk of venous thromboembolism... The risk of venous thromboembolism in women using oral oestrogen was higher in the first year of treatment (4.0, 2.9 to 5.7) compared with treatment for more than one year (2.1, 1.3 to 3.8; P<0.05).
Why this rating
Based on a systematic review and meta-analysis of 8 observational studies and 9 randomized controlled trials.
Source
Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis
Marianne Canonico et al. · BMJ · 2008
DOI 10.1136/bmj.39555.441944.be
More from this paper
- The combination of oral estrogen use with prothrombotic mutations (Factor V Leiden or Prothrombin G20210A) or obesity significantly enhances the risk of venous thromboembolism.Strong
- Transdermal estrogen does not significantly increase the risk of venous thromboembolism in postmenopausal women, unlike oral estrogen.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →