Do you consider co-prescribing hormone therapy and anticoagulation in a patient with prior DVT and uncontrollable VSM uncontrolled by non-hormonal therapies?

While I agree that you need to be thoughtful about adding additional VTE risk to patients with a history of VTE, I am much less concerned when patients are already on full-dose anticoagulation. Especially when the medication is transdermal estrogen, which has the lowest effect on thrombotic risk. I ...

I would not co-prescribe hormone therapy in a patient who is on anticoagulation for a prior DVT due to its pro-coagulant effect. Non-hormonal medications that can help with vasomotor symptoms include escitalopram, venlafaxine, and gabapentin. Usually, one of these 3 medications can relieve vasomotor...

It really would depend on the patient and potential risk factors. If the patient does not respond to venlafaxine, escitalopram, or gabapentin, I would discuss HT vs. fezolinetant. If there are additional menopausal symptoms that the patient is experiencing, I would lean towards HT. If the patient is...

To provide the appropriate answer, this question stems need considerably more information. What diagnosis? Are APLs positive? What were the circumstances of the blood clot? What other things have they tried for VSM?

HRT does not appear to increase risk in the studies that have been done. Here is one...