Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk

  title={Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk},
  author={Pierre-Yves Scarabin and Emmanuel Oger and Genevi{\`e}ve Plu-Bureau},
  journal={The Lancet},

Hormone replacement therapy and the risk of venous thromboembolism: a population‐based study

Transdermal HRT and tibolone were not associated with an increased risk of venous thromboembolism in postmenopausal women and the risks with oral formulations were particularly elevated during the first year of use but disappeared 4 months after discontinuation.

Hormone Therapy and Venous Thromboembolism Among Postmenopausal Women: Impact of the Route of Estrogen Administration and Progestogens: The ESTHER Study

Oral but not transdermal estrogen is associated with an increased VTE risk, and data suggest that norpregnane derivatives may be thrombogenic, whereas micronized progesterone and pregnane derivatives appear safe with respect toThrombotic risk.

Hormone therapy and recurrence of venous thromboembolism among postmenopausal women

Oral but not transdermal estrogens are associated with a higher risk of recurrent VTE among postmenopausal women, providing further epidemiological evidence that transder mal estrogens may be safe with respect to VTE risk.

Postmenopausal Hormone Therapy and Risk of Idiopathic Venous Thromboembolism: Results From the E3N Cohort Study

Oral estrogen therapy increases venous thromboembolism risk among postmenopausal women using hormone therapy and route of estrogen administration and concomitant progestogens type are 2 important determinants of thrombotic risk.

Prothrombotic Mutations, Hormone Therapy, and Venous Thromboembolism Among Postmenopausal Women: Impact of the Route of Estrogen Administration

In contrast to oral estrogen, transdermal estrogen does not confer additional risk on women who carry a prothrombotic mutation, and the safety of transDermal estrogen has to be confirmed in randomized trials.

Oral vs Transdermal Estrogen Therapy and Vascular Events: A Systematic Review and Meta-Analysis.

Observational evidence warranting low confidence suggests that compared to transdermal ET, oral ET may be associated with increased risk of VTE and DVT, but not MI.

Risk of venous thrombosis with oral versus transdermal estrogen therapy among postmenopausal women

Transdermal estrogens may improve substantially the benefit/risk ratio of postmenopausal hormone therapy and should be considered as a safer option, especially for women at high risk for VTE.

Less Effect of Intranasal Than Oral Hormone Therapy on Factors Associated With Venous Thrombosis Risk in Healthy Postmenopausal Women

Compared with oral E 2/NETA therapy, intranasal administration of E2/NET had less effect on APC resistance and on a number of other parameters associated with venous thrombosis.

Effects of transdermal versus oral hormone replacement therapy in postmenopause: a systematic review

VTE risk can be considered the clearest and strongest clinical difference between the two administration routes, supporting the transdermal HRT as safer than the oral administration route.



Hormone replacement therapy with estradiol and risk of venous thromboembolism--a population-based case-control study.

It is concluded that use of HRT containing estradiol was associated with a threefold increased risk of VTE, but this increased risk was restricted to the first year of use.

Assessment of the Risk for Venous Thromboembolism Among Users of Hormone Replacement Therapy

Current use of oral estrogen as HRT is associated with a 2- to 3-fold increased risk of venous thromboembolism, however, the absolute risk remains low, and these findings need to be weighed against the potential benefits of treatment.

Effects of oral and transdermal estrogen/progesterone regimens on blood coagulation and fibrinolysis in postmenopausal women. A randomized controlled trial.

Oral estrogen/progesterone replacement therapy may result in coagulation activation and increased fibrinolytic potential, whereas opposed transdermal estrogen appears without any substantial effects on hemostasis.

Hormone replacement therapy and risk of venous thromboembolism: population based case-control study

Current use of hormone replacement therapy was associated with a higher risk of venous thromboembolism, although the risk seemed to be restricted to the first year of use.

Postmenopausal Estrogen Replacement and Risk for Venous Thromboembolism

The venous thromboembolism risk with postmenopausal estrogen replacement therapy is estimated using a meta-analysis of eligible studies and fixed-effects and random-effects models using the Bayesian data analytic framework.

Hormone replacement therapy and the risk of hospitalization for venous thromboembolism: a population-based study in southern Europe.

Current users of hormone replacement therapy had 2.3 times higher risk of venous thromboembolism compared with nonusers, and the increased risk was restricted to the first year of treatment.

Postmenopausal hormone replacement therapy increases coagulation activity and fibrinolysis.

Coagulation activation may partly explain the increases in venous thrombosis and cardiovascular events reported with the use of combined HRT, and there were no associations between changes in hemostatic markers and lipids after treatment.