The results from the Danish registry study are further confirmation that hormone therapy for menopause taken in tablet form may be linked to an increased risk of blood clots in the legs and lungs. Treatment at high doses for a long time may also increase the risk of stroke and heart attack.
The results are consistent with what we already know and point to how important it is to address the shortcomings of this type of treatment, says Angelica Lindén Hirschberg, gynecologist and professor at Karolinska Institutet.
40,000 women
The researchers behind the study, published in the journal BMJ, looked at data on around 40,000 women aged 50 to 69 in Denmark who had been diagnosed with a venous blood clot, stroke or heart attack. The group was compared with women of the same age without these conditions. They also used prescription records to analyse their use of hormone therapy.
Estrogen in tablet form was consistently associated with an increased risk of venous thrombosis. However, the increased risk of stroke and heart attack was only seen among those who took doses above 1 milligram per day for over a year.
Extensive shortage
There was no increased risk among women who used patches, sprays or gels. For several years, there has been a widespread shortage of these, which has led to problems for many women.
However, the availability of estrogen tablets is good according to the Swedish Medical Products Agency. Angelica Lindén Hirschberg points out that for most people the increase in risk with tablets is not particularly large. However, patches, sprays and gels are preferable according to the results.
Anyone who is unsure should talk to their doctor, then they can decide which treatment is best, she says.
Right now, the supply of estrogen as a gel is good, but for patches and sprays, it is still difficult, according to the Medical Products Agency.
