Jonathan Douxfils: The Emerging Role of Estetrol in Menopausal Hormone Therapy
Jonathan Douxfils, Director of the Research Unit in Clinical Pharmacology and Toxicology at University of Namur, shared a post on LinkedIn:
“Last Thursday in Helsinki, I had the pleasure of presenting
‘Menopausal Hormone Therapy and Venous Thromboembolism: From Estrogenic Burden to Estetrol.’
As baseline venous thromboembolism risk increases with age, the choice of menopausal hormone therapy deserves careful consideration.
The route of administration matters, but so do the estrogen molecule and the accompanying progestogen.
My presentation focused on estetrol (E4), a natural estrogen with selective, tissue-specific activity and a distinctive effect on the liver and haemostatic system.
The menopause data discussed were particularly interesting.
After 52 weeks of treatment in the E4COMFORT II study, activated protein C resistance values remained within the reference range at the E4 doses evaluated.
The available biomarker evidence suggests that oral E4 may have a limited impact on haemostasis, resembling transdermal estradiol for the laboratory markers discussed.
These findings are encouraging, although biomarker data do not replace evidence from clinical outcomes.
Individual benefit-risk assessment remains essential when choosing menopausal hormone therapy.
E4 could be the first oral estrogen with a similar impact on the hemostatic system then transdermal E2.
Many thanks to Professors Helena Kopp Kallner and Marjo Tuppurainen, all the participating colleagues, and Gedeon Richter Nordics AB for an engaging evening of scientific discussion.”

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