Taking oral estrogen more than doubles the risk of venous thromboembolism (VT), according to a meta-analysis comprised of nine randomized controlled trials and eight observational studies.
The odds ratio for developing a clot among
current users of oral therapy was 2.5 compared
to non-users. This risk was highest in the first year of treatment, during which the odds ratio for developing VT was four. Conversely there was no significant elevated risk associated with estrogen given by transdermal patch.
The authors concluded that using this method of delivery could improve the safety and benefits of hormone replacement therapy. [BMJ 2008 May 31;336(7655):1227-31]
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