Study Links Oral Menopausal Hormone Therapy to Increased Thrombotic Risk
A recent nationwide nested case-control study published in BMJ has linked oral menopausal hormone therapy (MHT) to an increased risk of thrombotic events, including venous thromboembolism (VTE), ischemic stroke, and myocardial infarction (MI). The study found that high-dose oral estradiol (more than 1 mg daily) carried a higher risk for VTE (HR 1.8), ischemic stroke (HR 1.5), and MI (HR 1.4). Low-dose oral therapy (1 mg or less daily) also showed an increased VTE risk (HR 1.3) but no significant increase for stroke or MI. The risk for VTE was highest during the first year of high-dose oral therapy. In contrast, transdermal therapy was not associated with higher rates of VTE, ischemic stroke, or MI, with the exception of MI with transdermal combined cyclic therapy, which was based on sparse data. The study's authors noted limitations, including its observational nature and lack of data on BMI, smoking status, and age at menopause onset.
