SynthesisBMJ (Clinical research ed.)2008
Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 127 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Determining Dose Equivalence Between Oral and Transdermal Estrogen Treatment in Women With Turner Syndrome - A Randomized Study
Long Term Effects of Oral Versus Transdermal Estrogen Replacement Therapy in Turner Syndrome - A Randomized Trial
Who cites it
127 citing papers in PubMed, 13 syntheses or guidelines pooled it, 552 citations in OpenAlex.
- Brazilian Guideline on Menopausal Cardiovascular Health - 2024.Arquivos brasileiros de cardiologia · 2024Guideline
- Genome-wide investigation of exogenous female hormones, genetic variation, and venous thromboembolism risk.Journal of thrombosis and haemostasis : JTH · 2024Pooled it
- Effects of transdermal versus oral hormone replacement therapy in postmenopause: a systematic review.Archives of gynecology and obstetrics · 2023Pooled it
- Use of Hormone Therapy in Postmenopausal Women with Alzheimer's Disease: A Systematic Review.Drugs & aging · 2021Pooled it
- Menopausal hormone therapy and women's health: An umbrella review.PLoS medicine · 2021Pooled it
- Cardiovascular Changes in Menopause.Current cardiology reviews · 2021Pooled it
- Antipsychotic drug exposure and risk of venous thromboembolism: a systematic review and meta-analysis of observational studies.Drug safety · 2014Pooled it
- The 2012 hormone therapy position statement of: The North American Menopause Society.Menopause (New York, N.Y.) · 2012Guideline
- Menopausal symptoms.BMJ clinical evidence · 2011Pooled it
- Meta-analyses of adverse effects data derived from randomised controlled trials as compared to observational studies: methodological overview.PLoS medicine · 2011Pooled it
- Risk of recurrence after venous thromboembolism in men and women: patient level meta-analysis.BMJ (Clinical research ed.) · 2011Pooled it
- Menopausal symptoms.BMJ clinical evidence · 2010Pooled it
- Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009Pooled it
- Transdermal estrogen gel vs oral estrogen after hysteroscopy for intrauterine adhesion separation: A prospective randomized study.Frontiers in endocrinology · 2023Trial
- Transdermal oestradiol for androgen suppression in prostate cancer: long-term cardiovascular outcomes from the randomised Prostate Adenocarcinoma Transcutaneous Hormone (PATCH) trial programme.Lancet (London, England) · 2021Trial
- The Effect of Perimenopausal Transdermal Estradiol and Micronized Progesterone on Markers of Risk for Arterial Disease.The Journal of clinical endocrinology and metabolism · 2020Trial
- Occurrence and predictors of recurrence after a first episode of acute venous thromboembolism: population-based Worcester Venous Thromboembolism Study.Journal of thrombosis and thrombolysis · 2016Trial
- Metabolic effects of oral versus transdermal 17β-estradiol (E₂): a randomized clinical trial in girls with Turner syndrome.The Journal of clinical endocrinology and metabolism · 2013Trial
- Estrogen hormonal therapy is not associated with increased risk of venous thrombosis in total hip arthroplasty or hemiarthroplasty for femoral neck fractures.OTA international : the open access journal of orthopaedic trauma · 2026Article
- [Interpretation of 2024 United Kingdom National Osteoporosis Guideline Group (NOGG) Clinical Guidelines: Prevention and Treatment of Osteoporosis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
67 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the risk of venous thromboembolism in women using hormone replacement therapy by study design, characteristics of the therapy and venous thromboembolism, and clinical background.
designSystematic review and meta-analysis. DATA SOURCES: Medline. STUDIES REVIEWED: Eight observational studies and nine randomised controlled trials. INCLUSION CRITERIA: Studies on hormone replacement therapy that reported venous thromboembolism. REVIEW MEASURES: Homogeneity between studies was analysed using chi(2) and I(2) statistics. Overall risk of venous thromboembolism was assessed from a fixed effects or random effects model.
resultsMeta-analysis of observational studies showed that oral oestrogen but not transdermal oestrogen increased the risk of venous thromboembolism. Compared with non-users of oestrogen, the odds ratio of first time venous thromboembolism in current users of oral oestrogen was 2.5 (95% confidence interval 1.9 to 3.4) and in current users of transdermal oestrogen was 1.2 (0.9 to 1.7). Past users of oral oestrogen had a similar risk of venous thromboembolism to never users. The risk of venous thromboembolism in women using oral oestrogen was higher in the first year of treatment (4.0, 2.9 to 5.7) compared with treatment for more than one year (2.1, 1.3 to 3.8; P<0.05). No noticeable difference in the risk of venous thromboembolism was observed between unopposed oral oestrogen (2.2, 1.6 to 3.0) and opposed oral oestrogen (2.6, 2.0 to 3.2). Results from nine randomised controlled trials confirmed the increased risk of venous thromboembolism among women using oral oestrogen (2.1, 1.4 to 3.1). The combination of oral oestrogen and thrombogenic mutations or obesity further enhanced the risk of venous thromboembolism, whereas transdermal oestrogen did not seem to confer additional risk in women at high risk of venous thromboembolism.
conclusionOral oestrogen increases the risk of venous thromboembolism, especially during the first year of treatment. Transdermal oestrogen may be safer with respect to thrombotic risk. More data are required to investigate differences in risk across the wide variety of hormone regimens, especially the different types of progestogens.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.