How would you approach hormone replacement therapy for perimenopause in a patient with increased risk factors for VTE?
Risk factors such as hereditary thrombophilia without personal thrombosis, family history of thrombophilia or thrombosis, etc.
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What is your preferred therapy for perimenopausal HRT in patients with increased risk for VTE (no VTE hx)?
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2 Answers
Mednet MemberInvited Expert
Hematology · Medical University of South Carolina
Answered on
Like many medical choices, this decision involves weighing trade-offs—specifically, the risk of venous thromboembolism (VTE) versus the burden of severe menopausal symptoms. If we focus only on VTE risk (and set aside the trade-offs related to menopausal symptoms and the controversial issue of breas...
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Mednet MemberInvited Expert
Hematology · University of Rochester School of Medicine and Dentistry
Answered on
In addition to Dr. @Dr. First Last answer, the lowest effective dose via the transdermal route is generally felt to be safest. I would highly recommend the 2024 ASH Education Program articles in the category "Sex Hormones, Contraceptives, and Thrombotic Risk: Where Are We Now?"
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