Research
Hormonal
Transdermal estradiol (0.1 mg/day) does not significantly alter PAI-1 levels or enhance fibrinolysis in postmenopausal women, unlike oral estrogen.
If you use estrogen patches (transdermal), you likely will not get the fibrinolytic (clot-dissolving) benefits seen with oral estrogen pills. The patch does not significantly change PAI-1 levels.
GoodRefutesHIGH confidence
Transdermal estradiol caused no significant changes in PAI-1 levels from base-line values. There was no significant change from base line in PAI-1 levels after therapy with transdermal estradiol alone (P=0.608) or combined therapy (P=0.527).
Why this rating
Randomized crossover design.
Source
Effects of Hormone-Replacement Therapy on Fibrinolysis in Postmenopausal Women
Kwang Kon Koh et al. · New England Journal of Medicine · 1997
DOI 10.1056/nejm199703063361002
crossover · n=50Cited 376×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Oral conjugated estrogen (0.625 mg/day) and combined oral estrogen/progestin (0.625 mg estrogen + 2.5 mg medroxyprogesterone acetate) significantly reduce plasma PAI-1 levels by approximately 50% in postmenopausal women, thereby enhancing systemic fibrinolysis.Good
- Oral conjugated estrogen therapy enhances systemic fibrinolysis, as evidenced by increased D-dimer levels, which correlates inversely with the reduction in PAI-1 levels.Good
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