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

@article{Mohammed2015OralVT,
  title={Oral vs Transdermal Estrogen Therapy and Vascular Events: A Systematic Review and Meta-Analysis.},
  author={Khaled Mohammed and Abd Moain Abu Dabrh and Khalid Benkhadra and Alaa Al Nofal and Barbara Gisella Carranza Leon and Larry J. Prokop and Victor M. Montori and Stephanie S. Faubion and Mohammad Hassan Murad},
  journal={The Journal of clinical endocrinology and metabolism},
  year={2015},
  volume={100 11},
  pages={
          4012-20
        }
}
BACKGROUND Menopausal hormone therapy is widely used to alleviate climacteric symptoms but may increase the risk of venous and arterial vascular events. OBJECTIVE The objective was to synthesize the evidence about the risk of vascular events in postmenopausal women who use oral estrogen therapy (ET) and transdermal ET. METHODS We searched bibliographical databases through August 2013 for longitudinal comparative studies that enrolled postmenopausal women using either oral or transdermal ET… 
Oral versus transdermal estrogens and venous thromboembolism in postmenopausal women: what is new since 2003?
TLDR
A recent meta-analysis has confirmed the advantage of transdermal versus oral estrogens regarding VTE risk, despite divergences in rating the quality of evidence in this issue of Menopause.
Comparison of clinical outcomes among users of oral and transdermal estrogen therapy in the Women's Health Initiative Observational Study
TLDR
The summary index of risks versus benefits was similar for oral CEE versus oral or transdermal E2-containing regimens, and Findings were similar among women with hysterectomy taking estrogen alone.
Transdermal estrogen therapy in menopausal women at increased risk for thrombotic events: a scoping review
TLDR
Data regarding the safety of transdermal MHT use in postmenopausal women with risk factors for VTE is provided, and clinicians should have risk versus benefit discussions with each patient regarding its use.
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
TLDR
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.
The Effect of Perimenopausal Transdermal Estradiol and Micronized Progesterone on Markers of Risk for Arterial Disease.
TLDR
TE+IMP tended to improve cardiac autonomic control and prevented age-related changes in stress reactivity and endothelial function among healthy perimenopausal and early postmenopausal women.
In postmenopausal women, oral but not transdermal estrogen was associated with increased risk for stroke
  • S. Ott
  • Medicine
    Annals of Internal Medicine
  • 2016
TLDR
In postmenopausal women, current use of hormone therapy with oral, but not transdermal, estrogen was associated with increased risk for stroke, and use of estrogens with other progestogens was not associated withincreased risk.
Sex Steroids and Cardiovascular Outcomes in Transgender Individuals: A Systematic Review and Meta‐Analysis
TLDR
Low‐quality evidence suggests that sex steroid therapy may increase LDL‐C and TG levels and decrease HDL‐C level in FTM individuals, whereas oral estrogens may increase TG levels in MTF individuals.
The route of administration, timing, duration and dose of postmenopausal hormone therapy and cardiovascular outcomes in women: a systematic review
TLDR
Use of low-dose oral and transdermal HT appears to be safe with regard to CVD risk in women in menopausal transition and within the first years after menopause onset, andTransdermal estrogen with <50 μg/day of estrogen combined with micronized progesterone seems to be the safer choice with respect to thrombotic and stroke risk.
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TLDR
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.
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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.
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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.
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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.
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TLDR
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