Hormones and venous thromboembolism among postmenopausal women

  title={Hormones and venous thromboembolism among postmenopausal women},
  author={Pierre-Yves Scarabin},
  pages={34 - 37}
  • P. Scarabin
  • Published 15 November 2014
  • Medicine
  • Climacteric
Abstract Venous thromboembolism (VTE) is a common and potentially fatal disease in postmenopausal women. VTE has emerged as the most prevalent adverse effect of oral estrogens in 50–60-year-old women. Obesity and VTE history can be easily used to identify women at high risk but genetic screening is not cost-effective. Based on consistent biological and epidemiological findings, transdermal estrogen is the safest option with respect to VTE, especially in women at high risk. There is strong… 

Progestogens and venous thromboembolism in menopausal women: an updated oral versus transdermal estrogen meta-analysis

  • P. Scarabin
  • Medicine, Biology
    Climacteric : the journal of the International Menopause Society
  • 2018
Clinical findings emphasize the safety advantage of transdermal estrogen combined with progesterone and support the current evidence-based recommendations on HT, especially in women at high VTE risk.

Oral Contraceptives and HRT Risk of Thrombosis

This review attempts to summarize the current knowledge regarding the pathophysiology of oral contraceptive (OC) and hormone replacement therapy (HRT) -induced prothrombotic state in women, the risk of thrombosis associated with administration of various commercially available OCs and HRT, the additional risk in women with hereditary or acquired thromBophilia, and the currently available recommendations.

Risk of venous thromboembolism associated with local and systemic use of hormone therapy in peri- and postmenopausal women and in relation to type and route of administration

The risk of venous thromboembolism (VTE) is higher in users of systemic combined estrogen–progestogen treatment than in Users of estrogen only, and the risk of VTE was lower for women who used local estrogen than among those using oral estrogen only.

Effect of chronic estradiol plus progesterone treatment on experimental arterial and venous thrombosis in mouse

Tissue-specific interference of progesterone (P4) on the action of E2 in ovariectomized mice is reported, supporting the prominent role of estrogens and the accessory role of natural progestin on the extra-reproductive cells and tissues involved in thrombosis.

The Impact of Estrogen Receptor in Arterial and Lymphatic Vascular Diseases

The complex vascular effects of estrogens and selective estrogen receptor modulators (SERMs) that have been described using different transgenic mouse models with selective loss of ERα function and numerous animal models of vascular and lymphatic diseases are summarized.

Estetrol prevents western diet-induced obesity and atheroma independently of hepatic estrogen receptor (ER)α.

It is suggested that E4 could prevent metabolic, hepatic and vascular disorders occurring at menopause, extending the potential medical interest of this natural estrogen as a new hormonal treatment.

Towards optimization of estrogen receptor modulation in medicine

Sedentary work and risk of venous thromboembolism.

The hypothesis that sedentary work is a risk factor for venous thromboembolic events in the general population is not supported.

Menopausal Hormone Therapy: Current Considerations.

  • C. Stuenkel
  • Medicine, Psychology
    Endocrinology and metabolism clinics of North America
  • 2015

No sweat: managing menopausal symptoms at work

Most women would appreciate greater organizational support, specifically temperature control, flexible work hours and information about menopause for employees and managers, and most women did not believe that menopausal symptoms negatively impacted on their work.



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.

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.

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.

Effects of Oral and Transdermal Estrogen/Progesterone Regimens on Blood Coagulation and Fibrinolysis in Postmenopausal Women

The effects of oral and transdermal estradiol/progesterone replacement therapy on hemostatic variables were investigated to assess the true effects of estrogen-progestin regimens on blood coagulation and fibrinolysis.

Lower risk of cardiovascular events in postmenopausal women taking oral estradiol compared with oral conjugated equine estrogens.

In an observational study of oral hormone therapy users, CEEs use was associated with a higher risk of incident venous thrombosis and possibly myocardial infarction than estradiol use, and various oral estrogen drugs may be associated with different levels of cardiovascular risk.

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.

Estrogen Receptor Polymorphisms and the Vascular Effects of Hormone Therapy

Objective—To test whether estrogen receptor polymorphisms modify the effects of postmenopausal hormone therapy on biomarkers and on risk of coronary heart disease events, stroke, or venous

Synergism between oral estrogen therapy and cytochrome P450 3A5*1 allele on the risk of venous thromboembolism among postmenopausal women.

Women with CYP3A5*1 allele using oral estrogen can define a subgroup at high VTE risk, and additional data are needed to assess the relevance of this genetic biomarker in the medical management of menopause.