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Oral Menopause Hormone Therapy Linked to Increased Blood Clot Risk

A new study published in The BMJ suggests a link between oral menopause hormone therapy and an increased risk of blood clots and cardiovascular disease, particularly at higher doses.

  • Oral oestrogen replacement therapy is associated with an increased risk of venous thromboembolism, even for short durations.
  • High-dose oral oestrogen replacement therapy used for more than one to five years was linked to an increased risk of stroke or heart attack.
  • Oestrogen replacement patches applied to the skin were not associated with an increased risk of blood clots or cardiovascular disease.

A study published in The BMJ on 23 September 2026 has investigated a potential link between oral menopause hormone therapy and an increased risk of blood clots and cardiovascular disease, especially at higher doses.

The 'case-control' study, which involved women in Denmark, found that oral oestrogen replacement therapy was associated with an increased risk of venous thromboembolism, which includes leg vein clots. This risk was observed even with short-duration use.

For stroke or heart attack, the study indicated an increased risk only with high-dose oral oestrogen replacement therapy administered for more than one to five years. In contrast, oestrogen replacement patches applied to the skin did not show an associated increased risk.

Professor Robert F. Storey, Professor of Cardiology at the University of Sheffield, commented that the study's conclusions are well supported by its data. He noted that oral oestrogen replacement is known to stimulate the liver to increase factors that promote blood clot formation, while patches do not stimulate the liver in the same way.

What this means for you: If you are receiving oral oestrogen replacement therapy, it is important to ensure that risk factors for cardiovascular disease, such as cholesterol and blood pressure, are well controlled.

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