So many women have been afraid to use hormone therapy (HT) to ease their menopausal symptoms such as hot flashes and night sweats because the initial reporting of the WHI 2002 study linked the non-bioidentical versions of the female hormones estrogen and progesterone to an increased risk of breast cancer, heart attacks, and strokes.
Menopause, the Journal of North American Menopause Society (NAMS) published new research, from the Karolinska Institute in Stockholm led by Dr. Annica Bergendal, which found that overall, estrogen-only therapy carries a lower risk of blood clots than treatment with a combination of estrogen and progestin, the synthetic version of progesterone.
According to Science Daily, the study highlights that the way estrogen is delivered may impact the risks. There was no increased risk of VTE (venous thromboembolism) in this study for women who used transdermal estrogen (such as patches), either alone or in combination with a progestogen. And women who used vaginal estrogen alone to ease vaginal dryness and other symptoms of genitourinary syndrome of menopause (GSM) also had no increased risk of VTE. Many menopause experts don’t expect vaginal estrogen to raise the risk because absorption into the bloodstream is small and results in levels similar to those in postmenopausal women who use no hormones. But studies on this question have been rare, noted the authors, so this finding is a big help for decision making.
“This study adds to our knowledge that transdermal estrogen therapies are safer than oral, and that different estrogen or progestogen combinations may have different risks,” says NAMS Executive Director JoAnn V. Pinkerton, MD, NCMP. “The lack of blood clots with transdermal estrogen and with vaginal estrogen is very reassuring for women who need to continue taking hormones as they age when risk of blood clots increases.”