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Sep 30, 2013

Popular Estrogen Therapy May Increase Cardiovascular Risk

Study finds that the most-prescribed estrogen therapy may increase risk for blood clots and heart attack compared to other medications.

Many women take estrogen to reduce symptoms of menopause like hot flashes and night sweats, but not all therapies are created equal. According to a recent study, the No. 1 prescribed estrogen therapy may increase risk of blood clots and heart attack, causing concern among women considering these popular drugs.

Recently published in the Journal of the American Medical Association, this study compared the cardiovascular safety of two estrogen therapies: conjugated equine estrogens (brand name: Premarin) and estradiol (brand names: Estrace, Climara, Estraderm and Menostar). Prior studies suggest that Premarin may increase risk of blood clots and researchers wondered how this drug compared to estradiol. Does one therapy increase cardiovascular risk more than the other? And should women take this into account when deciding which therapy is right for them?

Among adults belonging to the Group Health Cooperative—a large health maintenance organization in Washington state—researchers identified 384 women aged 30-79 years old who took oral hormone therapy between 2003 and 2009. Over the study period, 68 women experienced blood clots, 67 suffered a heart attack and 48 experienced a stroke. Researchers found that women taking Premarin were more than twice as likely to have blood clots as women taking estradiol. Premarin was also associated with increased heart attack risk, but this difference was not considered statistically significant.

Authors strongly encourage further research on this topic, as safety information is crucial to decision making. Many women choose to take estrogen therapy to relieve symptoms of menopause, and it’s important to have as much information as possible when making safety decisions about various medications. And although further research is needed to confirm whether Premarin carries greater cardiovascular risk than other estrogen therapies, women considering taking these drugs should always discuss possible risks and benefits with their healthcare provider.

Questions for You to Consider

  • Why do some women take estrogen during menopause?
  • The estrogen in hormone therapy is used by some postmenopausal women to increase estrogen levels. This helps prevent osteoporosis and perimenopausal symptoms, such as hot flashes and sleep problems.
  • Is estrogen therapy safe?
  • Like all medications, oral estrogen therapy can cause certain side effects such as headaches, nausea, and weight gain. In rare cases, oral estrogen can cause more serious side effects. It’s important to discuss safety concerns with your doctor before taking any drugs.


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