Women navigating menopause have a new piece of guidance to discuss with their physicians. A study published in The BMJ confirms that women who take oral hormone therapy (HT) – whether low‑dose or higher‑dose estrogen – experience an increased risk of blood clots, and that higher estrogen doses also raise the chances of stroke and heart attack.
Key findings from the research
The investigators, based in Denmark, examined women using oral HT with estradiol, a bio‑identical form of estrogen. Participants who took 1 milligram of estradiol per day or more for at least a year showed a measurable rise in cardiovascular events compared with women who did not use oral HT. By contrast, women who used transdermal (skin‑applied) HT did not see the same elevated risk.
Importantly, the study highlighted that a daily low‑dose aspirin can mitigate the clotting risk associated with oral HT. While the research did not test aspirin directly, the authors noted that aspirin’s antiplatelet effect is a logical protective measure for women on oral estrogen.
What this means for patients
Physicians should consider three variables when prescribing HT: the form of estrogen (oral versus transdermal), the dosage, and the duration of therapy. Adding a low‑dose aspirin regimen may be advisable for women who remain on oral preparations, especially those on higher estrogen doses.
Patients are encouraged to have an open conversation with their healthcare providers about the safest HT option for their individual health profile. For many, a transdermal patch or gel can deliver the same symptom relief without the added clotting risk.
Expert commentary
Dr. Michael Roizen, chief wellness officer emeritus at the Cleveland Clinic, has long advocated for proactive health measures in older adults. While the article references his upcoming book, his broader message aligns with the study’s implication: preventive steps, such as low‑dose aspirin, can support women’s cardiovascular health during menopause.
Dr. Roizen emphasizes that lifestyle factors—regular exercise, balanced nutrition, and routine medical check‑ups—remain foundational. He adds that any decision to start aspirin should be made in partnership with a physician, taking into account personal bleeding risk and other medical conditions.
Practical steps for readers
- Ask your doctor whether oral or transdermal HT is more appropriate for you.
- If you stay on oral HT, discuss the possibility of a daily low‑dose aspirin (typically 81 mg) to reduce clot risk.
- Review your cardiovascular risk profile, including blood pressure, cholesterol, and family history.
- Maintain regular follow‑up appointments to monitor any side effects or changes in health status.
As research continues to refine menopause care, the combination of evidence‑based hormone therapy and simple preventive measures like low‑dose aspirin offers a promising path for women seeking relief from menopausal symptoms while protecting heart health.
Original reporting: Texarkana Gazette — read the source article.
