Oral hormone therapy pills double clot risk: study
Reuters News
Menopausal women who take hormone-replacement therapy pills more than
double their risk of developing a potentially fatal blood clot, French
researchers said on Friday.
The review of 17 studies suggested that the risk was also
significantly higher during the first year of treatment, they reported
in the British Medical Journal.
Blood clots in the arteries are a common cause of heart attacks and
strokes. Vein blood clots can kill if they move through the body to
the lungs.
"This meta-analysis ... showed that current use of oral oestrogen
increases the risk of (blood clots) by two-fold to three-fold," Pierre-
Yves Scarabin and Marianne Canonico of the Paul Brousse Hospital in
France wrote.
Hormone-replacement therapy relieves serious menopause symptoms such
as hot flashes and was popular until a 2002 study suggested it could
raise the risk of breast and ovarian cancer along with strokes and
other serious conditions.
The findings spurred millions of women to abandon the drugs, hitting
shares in makers of hormone therapies such as Wyeth.
Other experts, however, see that study as flawed and earlier this week
issued a statement saying their review of dozens of studies found HRT
is safe for early menopause and does not raise the risk of heart
disease for women aged 50 to 59.
Earlier trials had also linked the drugs to blood clots but the French
review marks the first systematic meta-analysis -- a look at what many
different studies have found -- to assess how big the increased risk
actually is.
"Although this relative risk is raised in hormone users when compared
to non-users, the absolute risk is indeed very small as blood clots do
not often occur in this age group in healthy women on no treatment,"
said David Sturdee, president of the International Menopause Society.
"This very slightly increased risk of a blood clot should not
discourage healthy women from using HRT if it is needed."
The analysis of eight observational studies and nine randomized
controlled trials found that hormone-replacement therapy given as a
patch showed no significant increased risk, unlike the pills.
A reason for the difference might be due to the different way
oestrogen is absorbed, they added. Further research was needed to
confirm the findings, they said.
When taken orally, oestrogen enters through the digestive system and
is processed by the liver. This might impair the balance between
clotting and anti-clotting factors in the blood, the researchers said.
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