Abstract
In their meta-analysis of studies on hormone replacement therapy (HRT), Canonico and colleagues reported that the risk of venous thrombosis was increased by 2.5-fold in current users of oral preparations, while the risk was not increased in those using transdermal hormone patches. Several large trials have shown that oral estrogens do not protect against, and might even increase the risk of, coronary heart disease, and slightly elevates the risk of breast cancer after prolonged use. On the basis of these results, HRT is no longer indicated for long-term use. Canonico et al.'s meta-analysis shows that when used over a short period of time to alleviate the symptoms of menopause, skin patches are likely to be safer than orally-administered hormones with respect to the risk of venous thrombosis, which is a potentially fatal complication.
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References
Canonico M et al. (2008) Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis. BMJ 336: 1227–1231
Wilson RA (1966) Feminine Forever. New York: WH Allen & Co.
Grady D et al. (1992) Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 117: 1016–1037
Barrett-Connor E et al. (1989) Postmenopausal estrogen use and heart disease risk factors in the 1980s: Rancho Bernardo, Calif, revisited. JAMA 261: 2095–2100
Vandenbroucke JP et al. for the STROBE Initiative (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Med 4: e297
Hulley S et al. (1998) Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women: Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 280: 605–613
Rossouw JE et al. Writing Group for the Women's Health Initiative Investigators (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 288: 321–333
Post MS et al. (2003) Effect of oral and transdermal estrogen replacement therapy on hemostatic variables associated with venous thrombosis: a randomized, placebo-controlled study in postmenopausal women. Arterioscler Thromb Vasc Biol 23: 1116–1121
Johnson JV et al. (2008) Effects of oral and transdermal hormonal contraception on vascular risk markers: a randomized controlled trial. Obstet Gynecol 111: 278–284
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Rosendaal, F. Hormone replacement therapy and thrombotic risk: beauty is only skin deep. Nat Rev Cardiol 5, 684–685 (2008). https://doi.org/10.1038/ncpcardio1346
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DOI: https://doi.org/10.1038/ncpcardio1346