Oral Menopausal Hormone Therapy Linked to Venous Thromboembolic Risk

THURSDAY, Oct. 8, 2026 (HealthDay News) — Oral menopausal hormone therapy use is associated with increased venous thromboembolic risk, according to a study published online Sept. 23 in The BMJ.

Julie Berggreen, from Steno Diabetes Center Copenhagen in Denmark, and colleagues examined associations between current use of menopausal hormone therapy and development of venous thromboembolism, ischemic stroke, and myocardial infarction in a nested case-control study of women aged 50 to 69 years. A total of 9,807 women with venous thromboembolism, 18,460 with ischemic stroke, and 11,974 with myocardial infarction were matched to 49,035, 92,300, and 59,870 women, respectively, without thrombotic disease by birth year.

The researchers found that the incidence rates of venous thromboembolism, ischemic stroke, and myocardial infarction were 15.8, 20.3, and 13.0 per 10,000 person-years among women who had not used menopausal hormone therapy, respectively. Current use of oral estrogen therapy (alone or combined with progestin) was associated with increased rates of venous thromboembolism, ischemic stroke, and myocardial infarction compared with no current use (hazard ratios, 1.6, 1.3, and 1.2, respectively). Compared with no current use, use of oral forms of estradiol was consistently associated with venous thromboembolic risk. Increased risks for ischemic stroke and myocardial infarction were seen in association with oral estradiol doses >1 mg/day for more than one year. No association was seen for transdermal therapy with increased thrombotic risks, apart from an increased risk for myocardial infarction with transdermal combined cyclic therapy.

“The thrombotic risk associated with contemporary systemic menopausal hormone therapy is influenced by the method of use, the daily estrogen dose, and treatment duration,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

Abstract/Full Text

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