Hormone patches or creams for menopause symptoms may have lower blood pressure risk than pills

Hormone therapy is commonly used by women to manage hot flashes and other symptoms associated with menopause. Recent research indicates that transdermal patches or creams might have fewer blood pressure risks compared to oral medications.

As menopause occurs, women’s bodies produce less reproductive hormones, leading to an increased risk of heart disease. Hypertension or high blood pressure, a significant risk factor for heart disease, may or may not be associated with hormone therapy used for menopausal symptoms.

A group of Canadian researchers sought to determine if the route of hormone absorption – oral, vaginal, or transdermal – could have an impact.

Scientists from the University of Calgary studied the health records of over 112,000 women aged 45 or older who had been prescribed at least six months of estrogen-only hormone treatment between 2008 and 2019. They observed which women developed hypertension at least one year after initiating treatment.

In findings that were not hugely significant but important, women who consumed estrogen pills had a 14% increased risk of hypertension compared to those using transdermal patches or creams, the researchers stated on Monday. In comparison to vaginal applications, oral estrogen carried a 19% higher risk.

The results were published in the Hypertension journal.

Hormone therapy, which entails a blend of risks and benefits, isn’t suitable for all women. It’s typically prescribed in the smallest effective dosage for the shortest duration, not as a preventive measure against disease, but to alleviate menopause-related symptoms. The most frequently used are combination pills containing estrogen and another hormone, progestin. Women without a uterus are typically prescribed estrogen-only pills.

The study did not explore which hormone therapy versions might be more effective for specific menopause symptoms.

Dr. Garima Sharma, a women’s heart specialist associated with the Inova Health System in Virginia and the American Heart Association, remarked that the study adds valuable insight into the intricate relationship between hormone therapy and blood pressure.

Dr. Sharma advocates for a more stringent trial comparing various hormone versions, pointing out a potential biological rationale: Oral estrogen might influence enzymes related to blood pressure during metabolism, whereas transdermal and vaginal applications may have less systemic effects.

Dr. Sharma stressed the clinical relevance of these findings in an email, recommending vigilant blood pressure monitoring in women using oral hormone therapy.

Support for the Big Big News Health and Science Department comes from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP holds exclusive responsibility for all content.

Frequently Asked Questions (FAQs) about Menopause Hormone Therapy

More about Menopause Hormone Therapy

• Understanding Menopause
• Hormone Therapy: Is it Right for You?
• High Blood Pressure and Women
• Hypertension Journal
• Inova Heart and Vascular Institute