Low Dose Hormone Patch Less Risky for Stroke than Pills

Kathleen Blanchard's picture
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Scientists say the way women taking hormone replacement therapy for postmenopausal symptoms could be related to risk for cerebrovascular events such as stroke. Low dose hormone replacement therapy or HRT patches with estrogen that deliver hormones through the skin may carry a lower risk of stroke, found in a newer study. The researchers say low dose hormone replacement therapy patches may be a safer alternative for treating postmenopausal symptoms that should be further explored.

Researchers investigated stroke incidence among 870,000 women aged 50-79 between January 1987 and October 2006. They compared women not using HRT to those given low dose hormone replacement therapy patches and oral hormones. Low dose estrogen patches seemed to be safest, with no association to having a stroke when the patches were compared to other forms of HRT. For oral hormone replacement therapy, stroke risk was 25 to 30 percent higher compared to women not using any hormones for postmenopausal symptoms.

Estrogen, progesterone, estrogen/progesterone and tibolone patches were studied. High dose HRT patches raised stroke risk by 88 percent. Women taking low dose estrogen patches had the same risk of stroke as women not using hormone therapy.

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The study also found that taking hormone replacement therapy for one year carried no risks. Longer use of oral HRT increased stroke risk for women by 35 percent. Longer use of oral hormones for postmenopausal hot flashes has also increases breast cancer risk and doubles a woman's risk of dying from lung cancer.

The authors write, "Our study suggests that the use of transdermal estrogen replacement therapy containing low doses of estrogen could be associated with a lower risk of stroke than the oral route of administration."

The researchers say the study does not prove that hormone replacement therapy with low dose estrogen patches should be advocated over oral HRT. However, it should prompt more research to help women find safer alternatives to deal with postmenopausal symptoms related to declining estrogen levels that cause hot flashes and other uncomfortable symptoms. The study shows that route of administration of hormone replacement therapy could be an important factor that might reduce health risks for women using HRT.

BMJ

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