Understanding the Link Between Hormone Therapy, Contraceptives, and Venous Thromboembolism (VTE)

Recent research raises important considerations about the risk of venous thromboembolism (VTE) associated with both types of hormone therapies. At Complete Healthcare for Women, we aim to provide a thorough understanding of these risks to help our patients make informed decisions about their health.

What Is Venous Thromboembolism (VTE)?

VTE refers to a condition where blood clots form in the veins, often in the legs (deep vein thrombosis) and lungs (pulmonary embolism). Although many factors can contribute to VTE, such as surgery, immobility, or cancer, hormone therapy is also recognized as a potential risk factor. This new study sheds light on how hormone exposure—whether through menopausal hormone therapy or contraceptives—can influence the risk of VTE in women.

Hormone Therapy and VTE Risk

For women experiencing symptoms of menopause, hormone therapy, particularly estrogen and progestogen, is often a key treatment. This study highlights that hormone therapy slightly increases the risk of VTE, but the risk remains relatively low.

The study found that for every 2,440 women using combined estrogen-progestogen therapy for menopausal symptoms, one additional case of VTE could be expected. This relatively low number suggests that, while there is a slight increase in risk, hormone therapy can still be a safe and effective treatment for most women, particularly when prescribed at low doses and for shorter durations. Importantly, the type of hormone therapy used can influence the risk, with transdermal therapies being associated with a lower VTE risk than oral therapies.

Contraceptives and VTE Risk

In contrast to menopausal hormone therapy, the study found that combined hormonal contraceptives (CHCs), such as birth control pills, significantly increase the risk of VTE. For every 132 women using CHCs, one additional case of VTE was observed. This highlights the markedly higher risk associated with contraceptives, largely due to the higher doses of synthetic hormones used in these medications compared to menopausal hormone therapy.

The synthetic estrogen and progestogens in contraceptives, such as ethinyl estradiol, are thought to be more potent in their effects on blood clotting. This makes it critical for women, particularly those with a history of clotting disorders or other risk factors, to discuss their options with their healthcare provider before starting or continuing CHCs.

What This Means for You

At Complete Healthcare for Women, we believe in individualized care. Whether you are considering hormone therapy for menopausal symptoms or evaluating your options for birth control, it’s important to weigh the benefits against potential risks. For menopausal hormone therapy, we work closely with our patients to ensure the lowest effective dose is used, often considering transdermal options to minimize risks.

For women considering CHCs, especially those with a family history of clotting disorders, we recommend having a detailed discussion about your personal risk factors. There are alternative options available for both contraception and hormone management, and our team is here to help guide you through these decisions.

Conclusion

While both menopausal hormone therapy and contraceptives come with certain risks, including the risk of VTE, the level of risk varies significantly between these treatments. At Complete Healthcare for Women, we are committed to providing personalized and evidence-based care, ensuring you have the information you need to make the best decisions for your health.

Complete Healthcare for Women - Obstetrics and Gynecology
509-392-6700
Richard Lorenzo, D.O.
Kortney Jones, ARNP

Author

Richard Lorenzo, DO Dr. Lorenzo is a Fellow of the American Congress of Obstetricians and Gynecologists (ACOG) and the American College of Osteopathic Obstetricians and Gynecologists (ACOOG), reflecting his expertise in women’s health. He provides comprehensive gynecological and obstetric services, including prenatal care up to 20 weeks, infertility evaluations, and general gynecology. Dr. Lorenzo specializes in advanced surgical techniques, offering minimally invasive procedures for abnormal uterine bleeding, endometriosis, and hysterectomy, ensuring quicker recovery and minimal discomfort for his patients. He is highly trained in high-risk obstetrics and adept at performing minimally invasive hysterectomies, providing women with effective solutions tailored to their needs. At Complete Healthcare for Women in Richland, WA, Dr. Lorenzo prioritizes personalized, compassionate care, empowering women to make informed health decisions.