Danish study: Hormonal treatment in tablet form increases the risk of blood clots

The results from the Danish registry study are further confirmation that hormone treatment during the menopause taken in tablet form can be linked to an increased risk of blood clots in the legs and lungs. Treatment in high doses for a longer period of time can also increase the risk of stroke and heart attack.

- The results agree well with what we already know and point to how important it is to address the shortcomings of that type of treatment, says Angelica Lindén Hirschberg, gynecologist and professor at the Karolinska Institutet.

The researchers behind the study, which is published in the journal BMJ, have looked at data for around 40,000 women between the ages of 50 and 69 in Denmark who have been diagnosed with a venous blood clot, stroke or heart attack. The group was compared with women of the same age without these diseases. They have also used prescription records to analyze their use of hormone drugs.

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 the dose above 1 milligram per day for over a year.

Among women who used plasters, sprays or gels, no increased risk was seen. For several years, there has been an extensive shortage of just these, which has led to problems for many women.

The supply of estrogen tablets is good, however, according to the Swedish Medicines Agency. Angelica Lindén Hirschberg points out that for most people the risk increase with tablets is not very great. But patches, sprays and gels are preferred according to the results.

- Anyone who is unsure should talk to their doctor, then you will find out which treatment is the best, she says.

At the moment, the availability of estrogen as a gel is good, but for patches and sprays it is still difficult according to the Swedish Medicines Agency.