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Hormone Therapy May Be Safer With Patch Than Pill
DALLAS, TX -- February 20, 2007 -- Transdermal estrogen, delivered by a patch or gel, is not associated with an increased risk of blood clots in veins, according to French researchers. The blood clots, called venous thromboembolism (VTE), are only a risk when taking estrogen by mouth.
Data from this multicenter case-control study of VTE among postmenopausal women also suggest that micronised progesterone and pregnane derivatives (medroxyprogesterone acetate) appear safe with respect to thrombotic risk. However, norpregnane derivatives cause clots.
The researchers looked at data on 271 women with first-ever VTE, and compared them to 610 women without VTE. The women in the EStrogen and THromboEmbolism Risk (ESTHER) study, which involved women 45 to 70 years old and was conducted between 1999 and 2005 in France.
Compared with women not taking estrogen replacement, those who used oral estrogen had a 4.2 times higher risk of VTE, while women using transdermal estrogen had 0.9 times the risk. The researchers found no significant association of VTE with micronised progesterone and pregnane derivatives. By contrast, norpregnane derivatives were associated with a 4-fold-increased VTE risk.
"If confirmed," said the authors, "these findings could benefit women in the management of their menopausal symptoms."
Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens. From the women's focus issue of Circulation: Journal of the American Heart Association.
The 2007 update provides the most current clinical recommendations for preventing CVD in women 20 and older and are based on a systematic search of the highest quality science interpreted by experts in the fields of cardiology, epidemiology, family medicine, gynecology, internal medicine, neurology, nursing, public health, statistics and surgery.
The authors note that these guidelines cover the primary and secondary prevention of chronic atherosclerotic vascular diseases. Recommendations for managing vascular disease before or after cardiac procedures or post-hospital and valvular heart disease are covered in other American Heart Association guidelines.
SOURCE: American Heart Association
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