Patrick Taylor: Oral vs Transdermal Estrogen and Cardiovascular Risk in Menopausal Women
Patrick Taylor, Chief Medical Officer at Belle, shared a post on LinkedIn:
”A nested case-control study in the BMJ (September 2026) drew on Danish national registries from 2003 to 2021, comparing 40,241 women aged 50 to 69 with venous thromboembolism, stroke, or myocardial infarction against 201,205 matched controls.
Oral estrogen was associated with higher risk of all three outcomes (hazard ratios roughly 1.6 for VTE, 1.3 for stroke, and 1.2 for MI), corresponding to about one additional VTE per 1,055, one stroke per 1,642, and one MI per 3,846 women treated for a year.
Transdermal estrogen showed no increase in any outcome, with one exception: transdermal estrogen with cyclic progestin carried an MI signal (HR 2.1).
Risk rose with higher oral doses and longer duration.
Route of administration remains one of the most consequential decisions in menopausal hormone therapy.”
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