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Women at Risk of Blood Clots; Is HRT Safe?



Introduction:

Navigating perimenopause and menopause can be a challenging journey for many women, marked by a myriad of symptoms stemming from hormonal fluctuations. Hormone Replacement Therapy (HRT) has long been hailed as a savior for alleviating these discomforts. However, a prevalent misconception persists, dissuading women with a history or heightened risk of blood clots from considering HRT as a viable option.


Blood clots, whether in the form of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE), pose significant health risks, and certain conditions or treatments can exacerbate this susceptibility. Sadly, misinformation perpetuates the notion that HRT is contraindicated for individuals with a predisposition to clotting issues.


Dispelling Misconceptions:

Historically, older types of HRT did pose a slight uptick in the risk of blood clot formation, leading to understandable caution among healthcare providers. However, advancements in medical research have shed new light on the safety profile of contemporary HRT formulations.


The Crucial Distinction:

Crucially, the method of estrogen delivery plays a pivotal role in mitigating clotting risks. While oral estrogen intake has been associated with an elevated clotting propensity, transdermal estrogen administration, via patches, gels, or sprays, sidesteps this concern entirely. Estogen through the skin DOES NOT CAUSE BLOOD CLOTS.


Choosing the Right Progestogen:

For individuals requiring progesterone supplementation alongside estrogen therapy, the choice of progestogen is equally critical. Micronized progesterone, such as Prometrium, emerges as the preferred option, it does not have clotting risks associated with synthetic progestogens.


The Evidence Speaks:

Recent studies have underscored the safety of transdermal estrogen and micronized progesterone for women grappling with clotting disorders like Factor V Leiden, or contending with conditions such as cancer or lupus. Contrary to outdated perceptions, HRT remains a viable option for symptom management in these cohorts.


Seeking Informed Guidance:

Regrettably, lingering misconceptions surrounding HRT persist, leading to unwarranted apprehension among both patients and healthcare providers. If you've been dissuaded from pursuing HRT due to clotting concerns, seeking a second opinion from a knowledgeable practitioner well-versed in contemporary evidence is prudent.


Conclusion:

In the evolving landscape of menopausal management, empowering women with accurate information regarding HRT's safety profile is paramount. By dispelling myths and embracing evidence-based practices, we can ensure that every individual receives personalized care tailored to their unique needs, free from unwarranted fear and misinformation.


Dr Purity Carr

Menopause Doctor & GP

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