HRT tablets may increase the risk of serious blood clots

The study used data from the two largest United Kingdom primary care databases (QResearch and CPRD), which contain patient records from more than 2,000 English GP practices and associated hospital records over an 18-year period (1998-2017) to investigate real-life use and risks of blood clots for all types of HRT treatments.

Those who took pills were 58 per cent more likely to develop a risky clot, which equates to more than 100 extra women suffering the life threatening.

Australian women are being reassured that hormone replacement therapy is safe after a large study uncovered more details on the increased risk of blood clots.

HRT is used to prevent a range of symptoms experienced by many women during the menopause, such as hot flushes and night sweats. It works by replacing the female hormone oestrogen as the body stops producing it. HRT can also be taken in different forms - by tablets, patches, gels or creams. Both for single and combined hormone treatments, the risk of blood clots was 15 per cent higher for the treatments containing oestrogen manufactured from horse urine than for the synthetic oestradiol. However, there appears to be no increased risk when using HRT skin patches, gels and creams.

Researchers stress that the absolute risk remains small. This means that the oral HRT use was associated with a 58% (adjusted odds ratio [OR] 1.58; 95% confidence interval [CI] 1.52-1.64) increased risk of VTE compared with no exposure, which is equivalent to 9 extra cases of VTE per 10,000 treated each year.

But in 2015, health watchdog Nice issued new guidance advising Global Positioning System to start offering the drug to more women, saying the cancer fears had been overblown.

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"While this study is certainly interesting and important, as the authors themselves acknowledge, the findings do not prove that tablets cause more DVTs [deep vein thrombosis] than patches, just that there is an association".

'Best practice is to prescribe the lowest possible dose of HRT for the shortest possible time, and so specific products and formulations of HRT are only initiated after a comprehensive discussion'.

Dr Channa Jayasena, of Imperial College London, added: 'We know that HRT has important benefits to alleviate menopausal symptoms. All drugs have side effects.

'This helpful study allows us to see which types of HRT have the highest and lowest risk.

"HRT patches have the lowest risk of blood clots, and should be first-choice for older women".

Dr Farrell says women should not be alarmed by the latest study.

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