Pulmonary embolism in menopausal hormone therapy: a population-based register study

Autor:	M. Sundell, A.-C. Spetz Holm, M. Fredrikson, M. Hammar, M. Hoffmann, J. Brynhildsen
Rok vydání:	2022
Předmět:	Estrogen Replacement Therapy Obstetrics and Gynecology Reproduktionsmedicin och gynekologi Estrogens General Medicine Medroxyprogesterone Acetate Administration Cutaneous Risk Factors Obstetrics Gynecology and Reproductive Medicine Case-Control Studies Menopausal hormone therapy hormone replacement therapy venous thromboembolism pulmonary embolism transdermal treatment cutaneous administration progestins estrogens register study population study Humans Female Progestins Menopause Pulmonary Embolism
Zdroj:	Climacteric : the journal of the International Menopause Society. 25(6)
ISSN:	1473-0804
Popis:	Objective Oral but not transdermal menopausal hormone therapy (MHT) increases the risk of venous thromboembolism. There is no evidence regarding the risk of the serious complication pulmonary embolism (PE). The aim was to investigate the risk of PE in women using MHT depending on administration route, type of progestin and treatment duration. Method The population-based case-control study covered 1,771,253 women aged 40-69 years, during 2006-2015. Diagnoses of PE (n = 13,974) and drug dispensations were received from national validated registers. Results Current MHT users had a higher risk of PE than non-users (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.05-1.26). First ever users had the highest risk (OR 2.07, 95% CI 1.23-3.50). Transdermal administration was not associated with increased risk of PE. The OR was slightly but non-significantly higher with estrogen combined with medroxyprogesterone acetate than with norethisterone acetate. Discussion The risk of PE was significantly increased in users of oral but not transdermal MHT, with the highest risk in first ever users of oral estrogen combined with medroxyprogesterone acetate. The risk was considerably lower in women with recurrent treatment, probably because of the healthy user effect. Conclusion PE was most common close to initiation of oral treatment. Transdermal MHT did not increase the risk of PE.
Databáze:	OpenAIRE
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