Patches for Hormone Replacement Therapy Better than Pills

It’s well-known that hormone replacement therapy (HRT) carries the risk of deep vein thrombosis, which can sometimes result in the more dangerous pulmonary embolism.  Although there are different methods for managing menopausal symptoms, HRT is still commonly prescribed.  Clinical trials of a skin patch form for combined estrogen-progesterone administration has shown that it is less likely to cause venous thrombosis than oral administration.  Though it’s likely that the same would hold true for an estrogen-only patch, the drug maker Novartis funded a real-world type study.  The results are published in the journal Menopause.

A large marketing database provided information on 54,000 women over 35 who were newly using an estradiol transdermal patch system or oral estrogen-only HRT.  Cases of deep venous thrombosis or pulmonary embolism were compared in the two groups.

The women taking estrogen-only pills yielded 164 cases of venous thromboembolism for an annual rate of 0.6%, compared with a rate of 0.4% in the women using the estrogen patch.  These percentages are small, but the consequences of deep venous thrombosis can be devastating, so that it might be advisable for women who want to try HRT to treat their hot flashes to use patches rather than pills.

The alternatives to HRT for menopausal symptoms include some antidepressants, changing the environment (e.g. sleeping in a cool room), limiting caffeine, alcohol, and spices, yoga, and meditation. Herbal remedies are not considered effective.