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The Question of Hormone Therapy: Does Your Physician Know Post-menopausal Hormone Therapy Could Increase Your Risk of a Serious Blood Clot?

blood clot risks

Since a landmark study suggested that the risks of hormone therapy outweigh the benefits, women—and their physicians—have wondered how to safely treat symptoms of menopause.

The Women’s Health Initiative (WHI) is a large, long-term study aimed at collecting data to help women understand and prevent serious conditions more likely to afflict post-menopausal women like heart disease, colorectal cancer, breast cancer, and frailty.  In 2002, a WHI study published in JAMA sounded the alarm that hormone therapy (HT) played a part in increased risk of blood clots, breast cancer, and cardiovascular disease in a large cohort of post-menopausal women between the ages of 50 and 79 years of age.  So significant were the findings that researchers halted the study out of concern for participants who were using HT.

New Studies Bring New Information

As expected, fewer physicians prescribed HT for their post-menopausal patients in the years following the study up until the present day.  Recent studies looking at the safety of HT have suggested that it may be beneficial to women with knee osteoarthritis and that vaginal use of estrogen is not linked to higher risk of cancer or cardiovascular disease.

Yet another recent study echoes findings of the original study—that HT medication may increase the risk of life-threatening blood clots called venous thromboembolism (VTE).   Published in the BMJ, the British study evaluated data from over 470,000 women between the ages of 40 and 79.

As we have discussed, venous thromboembolism is a serious cause of stroke, pulmonary embolism, and heart attack.  According to the American Heart Association,  VTE is responsible for blood clots that impact between 300,000 and 600,000 people per year in the United States.  Primary types of VTE include:

  • Deep vein thrombosis (DVT): Blood clots that form deep within the body in the abdomen or legs
  • Pulmonary embolism (PE): DVTs that break off and travel to the lung causing vascular events in the lungs and brain that can be fatal

The BMJ study confirmed that HT increases risk of these dangerous blood clots when the drug is delivered orally, through a pill.  The study suggests that transdermal drug delivery, through a patch or cream does not increase risk.

If you are post-menopausal and your physician suggests HT, be sure to discuss the benefits, risks, and what type of therapy is safest for your medical aims and history.

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