Contemporary menopausal hormone therapy and thrombotic disease: nationwide nested case-control study.

Current oral menopausal hormone therapy significantly increases the risk of venous thromboembolism, ischaemic stroke, and myocardial infarction, especially with prolonged high-dose use.

• Why it matters: Understanding the thrombotic risks associated with hormone therapy is crucial for informed decision-making in menopausal women, as existing data on specific formulations and durations are limited.
• What they did: The study analyzed nationwide Danish health registry data, comparing nearly 50,000 women with thrombotic events to matched controls, focusing on hormone therapy types, doses, and durations.
• The result: Oral hormone therapy was linked to higher thrombotic risks regardless of dose or duration, with high-dose oral oestradiol (>1 mg/day) notably increasing stroke and heart attack risks over time; transdermal therapy showed no such risks.