A new study from Sweden reveals that certain hormone replacement therapy (HRT) tablets, used to ease menopause symptoms, may increase the risk of heart disease and blood clots in women around menopause.
Published in The BMJ, the research highlights how different types of HRT and how they are administered can impact cardiovascular health.
What is HRT?
HRT is a treatment for menopausal symptoms like hot flashes and night sweats.
It can involve different hormone combinations, such as estrogen and progestogen, and can be taken as tablets, patches, gels, or creams.
While HRT helps many women, some forms may carry health risks.
Researchers analyzed data from 919,614 healthy Swedish women aged 50–58 who had not used HRT in the previous two years. The study spanned from 2007 to 2020, and women with a history of heart disease, stroke, or cancer were excluded.
The women were grouped into eight HRT categories, including various tablet combinations and transdermal methods (like skin patches). They were followed for two years to track cardiovascular events such as heart attacks, strokes, and blood clots.
- Oral HRT Risks: Women taking oral combined continuous therapy (estrogen and progestogen tablets) or tibolone (a synthetic hormone) had a higher risk of heart disease. The study estimated 11 new cases of heart disease per 1,000 women using these treatments over one year.
- Blood Clots: An increased risk of venous thromboembolism (serious blood clots) was found for several oral treatments, including oral combined continuous, oral combined sequential, and oral unopposed estrogen. Even some transdermal combined treatments carried this risk, with about seven new cases of blood clots per 1,000 women annually.
- Tibolone Risks: Tibolone was also linked to a higher risk of stroke and heart attack, but not blood clots.
- Safer Options: Transdermal treatments, such as skin patches, gels, and creams, did not show an increased risk of cardiovascular disease.
Since this was an observational study, it cannot prove that HRT causes heart disease or blood clots.
The researchers also lacked data on factors like smoking and BMI, which could influence the results.
However, the study used advanced methods to reduce bias and relied on registry data to distinguish between different types of HRT.
The study underscores the importance of considering the type and method of HRT when managing menopause symptoms. Oral HRT pills with certain hormone combinations may pose higher risks for heart disease and blood clots, while transdermal options appear safer.
The authors emphasize that future research should explore how different progestogens and delivery methods affect cardiovascular risk, helping women make informed choices about their treatment.
If you are considering or currently using HRT, talk to your healthcare provider to understand the best options for your health needs.
If you care about heart health, please read studies about the best time to take vitamins to prevent heart disease, and scientists find how COVID-19 damages the heart.
For more information about heart health, please see recent studies about Aspirin linked to higher risk of heart failure, and results showing Blackcurrants could improve artery functions, blood pressure in older people.
