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Venous thromboembolism and hormone replacement therapy.
1Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Department of Internal Medicine, IRCCS Maggiore Hospital and University of Milan, Via Pace 9, 20122, Milan, Italy.
European Journal of Internal Medicine
|November 17, 2001
Summary
Hormone replacement therapy increases blood clot risk in postmenopausal women. Women with a history of venous thromboembolism (VTE) should avoid hormone therapy due to this elevated risk.
Area of Science:
- Biomedical Science
- Endocrinology
- Hematology
Background:
- Postmenopausal hormone replacement therapy (HRT) is associated with biochemical changes.
- Estrogen and progestogen therapies, regardless of administration route, can affect coagulation.
- Previous studies suggested a link between HRT and hypercoagulability.
Purpose of the Study:
- To evaluate the risk of venous thromboembolism (VTE) associated with hormone replacement therapy in postmenopausal women.
- To determine if HRT significantly increases the incidence of VTE.
- To provide evidence-based recommendations for HRT use in women with and without VTE risk factors.
Main Methods:
- Analysis of two recent randomized, double-blind clinical trials.
- Assessment of biochemical markers of hypercoagulability, including coagulation enzyme activity.
- Evaluation of VTE incidence in postmenopausal women using HRT compared to controls.
Main Results:
- Hormone replacement therapy was found to induce biochemical hypercoagulability.
- HRT use was linked to an increased risk of venous thromboembolism (VTE).
- The absolute excess risk of VTE was small in women without other risk factors.
Conclusions:
- Postmenopausal women using hormone replacement therapy exhibit increased hypercoagulability.
- Hormone replacement therapy increases the risk of venous thromboembolism.
- Women with a history of VTE should not be prescribed hormone replacement therapy due to the elevated risk.