Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases

Risks of transdermal HRT

Vinogradova and colleagues found ‘recent’ exposure to combined continuous or cyclical oral HRT or oestrogen only HRT increased risk of venous thromboembolism significantly compared with no ‘recent’ exposure in women age 40 to 79 to nearly double. Estradiol HRT had a lower risk than conjugated equine oestrogen HRT. Transdermal HRT did not seem to increase the risk of venous thromboembolism but the overwhelming preference among study women was for oral preparations.1

Although the latest HRT fashion is transdermal bio-identical progesterone and estradiol to lower the venous thromboembolic risk, transdermal progesterone has not been proved to protect against endometrial cancer when given with oestrogen to postmenopausal women who still have a uterus.2

The menopause is a normal physiological event and should be around age 50 and not age 40 to 79. Older women are therefore protected from unnecessary increases in circulating oestrogen and/or progesterone levels which are potentially dangerous. Progesterone and oestrogens up and down regulate thousands of genes and increase the risk of breast, ovarian, endometrial and cervical cancers, arterial and venous vascular diseases, mental and immune diseases.

Vasomotor symptoms such as flushing, headaches or migraines have many causes including drug or steroid withdrawal, toxic metal sensitivities and increased bacterial or fungal gut fermentation with increases in blood ethanol levels in response to a glucose drink after fasting.3 Also adverse reactions to alcoholic drinks, tobacco smoking, coffee, food and chemicals, and nutritional deficiencies, are increased by use of sex hormones.4,5 Monitored repletion of essential nutrients is needed and is also important for the prevention and treatment of osteoporosis.6 Progestogen use can cause micro-thrombi in bone blood vessels. Fracture incidences increased in women in countries using both contraceptive and menopausal hormones.7 Osteoporosis can increase in severity when hormone levels fall at the menopause or if exogenous hormones are discontinued. However, osteoporosis is mainly due to essential nutrient deficiencies, especially of zinc, magnesium and vitamin D.8 Steroid withdrawal vasomotor symptoms can be more safely treated by avoidance of precipitants, treatment of infections and monitored nutritional supplementation rather than continuing to take immunosuppressive, carcinogenic, thrombogenic and psychoactive hormonal steroids. It is irresponsible to continue to promote progesterone and/or estrogen use to treat complicated medical problems.

HRT may be a huge money spinner but its promotion by “Forever Estrogen” lovers is dangerously unscientific.

website www.harmfromhormones.co.uk

1 Vinogradova Y, Coupland C, Hippisley-Cox J, et al. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ 2019;364:k4810.
2 Wren BG. Transdermal progesterone creams for postmenopausal women: more hype than hope. Med J Aust 2005; 182 (5): 237-239.
3 Hunnisett A, Howard J, Davies S. Gut fermentation (or the auto-brewery syndrome): a new clinical test with observations and discussion of clinical and biochemical implications. J Nutr Med 1990:1:33-38.
4 Grant ECG. Oral contraceptives, smoking, migraine and food allergies. Lancet 1978;2:581-82.
5 Grant ECG. Food allergies and migraine. Lancet 1979;1:966-69.
6 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity and mineral imbalance. J Nutr Environ Med 1998:8:789-91.
7 Little K. Progestogens: Thrombosis and osteoporosis, J Nutr Environ Med;8:139-152.
8 McLaren-Howard J, Grant ECG, Davies, S. Hormone replacement therapy and osteoporosis: bone enzymes and nutrient imbalances. J Nutr Environ Med. 1998;8:129–138.