“Although the risks of blood clots and stroke increase with either type of hormone therapy, the risk is rare in women ages 50-59”.1

Umbrella
What may the Hormone Therapy and Blood Clots Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Blood Clots
  • Deep Vein Thrombosis (DVT)
  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Therapy (MHT)
  • Venous Thromboembolism (VTE)
  • Venous Thrombosis

Revised Global Consensus Statement

Is there an association between menopausal hormone therapy (MHT) and the risk of blood clots?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016 is:

Hormone Therapy and Blood Clots

  • “The risk of venous thromboembolism (VTE) and ischemic stroke increases with oral MHT, although the absolute risk of stroke with initiation of MHT before age 60 years is rare. Observational studies and a meta-analysis point to a probable lower risk of VTE and possibly stroke with transdermal therapy (0.05 mg twice weekly or lower) compared to oral therapy”.2

NICE Guideline

What do the (British) National Institute for Health and Care Excellence (NICE) guidelines note about HT and the risk of blood clots?

In Menopause: Diagnosis and Management – Information for the Public: Benefits and Risks of HRT – Blood Clots (Venous Thromboembolism) the NICE note:

“HRT tablets (but not patches or gels) are linked with a higher risk of developing a blood clot. If you are already at higher risk of blood clots (for example, you are obese) and you are considering HRT, you may be offered patches or gel rather than tablets. If you have a strong family history of blood clots or if there’s another reason why you are at high risk of blood clots, you may be referred to a haematologist (a doctor who specialises in blood conditions) before considering HRT”.3

Health Care Provider

If I choose to use HT what is my risk of blood clots?

Different women who choose to use HT can have different risks of blood clots. It may therefore be in your best interest to also choose to talk to your health care provider about this.

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT is:

  • “The option of MHT is an individual decision in terms of quality of life and health priorities as well as personal risk factors such as age, time since menopause and the risk of VTE, stroke, ischemic heart disease and breast cancer. MHT should not be recommended without a clear indication for its use”.4

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Sources

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You may find the Sources quoted at:

Sources

  1. 15 Top Medical Organizations Agree on Hormone Therapy Use: 10 Years Have Passed Since Women’s Health Initiative Raised Questions. 09 July 2012:3. North American Menopause Society, the American Society for Reproductive Medicine and the Endocrine Society https://www.menopause.org/docs/default-document-library/pr12solidarity.pdf?sfvrsn=2 Accessed: 29 April 2020
  2. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:314 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 29 April 2020
  3. Menopause Diagnosis and Management: Information for the Public – Benefits and Risks of HRT: Blood Clots (Venous Thrombolembolism). Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Benefits-and-risks-of-HRT Accessed: 29 April 2020
  4. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT. Climacteric, 2016;19:4:314 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 29 April 2020
Topic Last Updated: 29 April 2020 – Topic Last Reviewed: 29 April 2020
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