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Published on: August 13, 2019
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Pulmonary embolism in menopausal hormone therapy: a population-based register study.
M Sundell1,2, A-C Spetz Holm2,3, M Fredrikson2
1Department of Obstetrics and Gynecology, Kalmar County Hospital, Kalmar, Sweden.
Climacteric : the Journal of the International Menopause Society
|October 11, 2022
Summary
Oral menopausal hormone therapy (MHT) increases pulmonary embolism (PE) risk, especially for new users. Transdermal MHT does not raise PE risk, offering a safer alternative for women seeking symptom relief.
Area of Science:
- Reproductive Medicine and Endocrinology
- Cardiovascular Health
- Pharmacovigilance
Background:
- Menopausal hormone therapy (MHT) is widely used for symptom management.
- Oral MHT is linked to venous thromboembolism, but PE risk remains unclear.
- Understanding MHT's impact on PE is crucial for patient safety.
Purpose of the Study:
- To investigate the risk of pulmonary embolism (PE) in women using MHT.
- To analyze PE risk based on MHT administration route (oral vs. transdermal).
- To examine the influence of progestin type and treatment duration on PE risk.
Main Methods:
- Population-based case-control study involving over 1.7 million women aged 40-69.
- Utilized national validated registers for PE diagnoses and drug dispensations (2006-2015).
- Compared PE risk between current MHT users and non-users, stratifying by MHT characteristics.
Main Results:
- Current MHT users showed a higher risk of PE (OR 1.15).
- First-time oral MHT users faced the highest PE risk (OR 2.07).
- Transdermal MHT was not associated with an increased PE risk.
Conclusions:
- Oral MHT significantly increases PE risk, particularly with initial use.
- Transdermal MHT does not elevate PE risk, suggesting a safer route of administration.
- Risk reduction in recurrent users may be due to the healthy user effect.
Keywords:
Menopausal hormone therapycutaneous administrationestrogenshormone replacement therapypopulation studyprogestinspulmonary embolismregister studytransdermal treatmentvenous thromboembolismMore Related Videos
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