Book contents
- Managing the Menopause
- Managing the Menopause
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Physiology of the Menstrual Cycle and Changes in the Perimenopause
- Chapter 2 Clinical Features of the Menopause/Postmenopause
- Chapter 3 The Ovarian Reserve
- Chapter 4 Premature Ovarian Insufficiency
- Chapter 5 Premature Ovarian Insufficiency
- Chapter 6 Natural Hormone Replacement Therapy after Menopause by Ovarian Tissue Transplantation
- Chapter 7 Migraine in the Menopause
- Chapter 8 Psychological Aspects of the Menopause
- Chapter 9 Memory and Mood in the Menopause
- Chapter 10 Libido and Sexual Function in the Menopause
- Chapter 11 Vulvo-Vaginal Atrophy (VVA)
- Chapter 12 Pelvic Floor, Urinary Problems and the Menopause
- Chapter 13 The Effect of Menopause on the Musculoskeletal System
- Chapter 14 Hormonal Management of Osteoporosis during the Menopause
- Chapter 15 Cardiovascular Disease and the Menopause
- Chapter 16 Gynecological Pathology in the Menopause (Excluding Cancers)
- Chapter 17 Nutrition and Weight Gain in the Menopause
- Chapter 18 The Use of Estrogens and Progestogens in Menopausal Hormone Therapy
- Chapter 19 Androgen Therapy for Postmenopausal Women
- Cahpter 20 Contraception for the Perimenopausal Woman
- Chapter 21 Hormone Therapy and Cancer
- Chapter 22 Menopausal Hormone Therapy (MHT) and Venous Thrombosis
- Chapter 23 The Risk–Benefit Analysis of Menopausal Hormone Therapy in the Menopause
- Chapter 24 Selective Estrogen Receptor Modulators (SERMs) and Menopausal Hormone Therapy (MHT)
- Chapter 25 Non-hormonal Treatments for Menopausal Symptoms
- Chapter 26 Alternative Therapies for the Management of Menopausal Symptoms
- Chapter 27 Menopause in Primary Care
- Index
- References
Chapter 22 - Menopausal Hormone Therapy (MHT) and Venous Thrombosis
Published online by Cambridge University Press: 18 June 2020
- Managing the Menopause
- Managing the Menopause
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Physiology of the Menstrual Cycle and Changes in the Perimenopause
- Chapter 2 Clinical Features of the Menopause/Postmenopause
- Chapter 3 The Ovarian Reserve
- Chapter 4 Premature Ovarian Insufficiency
- Chapter 5 Premature Ovarian Insufficiency
- Chapter 6 Natural Hormone Replacement Therapy after Menopause by Ovarian Tissue Transplantation
- Chapter 7 Migraine in the Menopause
- Chapter 8 Psychological Aspects of the Menopause
- Chapter 9 Memory and Mood in the Menopause
- Chapter 10 Libido and Sexual Function in the Menopause
- Chapter 11 Vulvo-Vaginal Atrophy (VVA)
- Chapter 12 Pelvic Floor, Urinary Problems and the Menopause
- Chapter 13 The Effect of Menopause on the Musculoskeletal System
- Chapter 14 Hormonal Management of Osteoporosis during the Menopause
- Chapter 15 Cardiovascular Disease and the Menopause
- Chapter 16 Gynecological Pathology in the Menopause (Excluding Cancers)
- Chapter 17 Nutrition and Weight Gain in the Menopause
- Chapter 18 The Use of Estrogens and Progestogens in Menopausal Hormone Therapy
- Chapter 19 Androgen Therapy for Postmenopausal Women
- Cahpter 20 Contraception for the Perimenopausal Woman
- Chapter 21 Hormone Therapy and Cancer
- Chapter 22 Menopausal Hormone Therapy (MHT) and Venous Thrombosis
- Chapter 23 The Risk–Benefit Analysis of Menopausal Hormone Therapy in the Menopause
- Chapter 24 Selective Estrogen Receptor Modulators (SERMs) and Menopausal Hormone Therapy (MHT)
- Chapter 25 Non-hormonal Treatments for Menopausal Symptoms
- Chapter 26 Alternative Therapies for the Management of Menopausal Symptoms
- Chapter 27 Menopause in Primary Care
- Index
- References
Summary
Venous thromboembolism (VTE) is a specific reproductive health risk for women. In pregnancy the relative risk of VTE is increased approximately 5-fold and in the puerperium it is increased by as much as 60-fold. Additionally, large numbers of women worldwide are exposed to an increased relative risk of VTE as a result of using combined hormonal contraception (CHC), in particular combined oral contraceptives (COCs). Even women undergoing infertility treatment may be exposed to situations of significantly increased risk of VTE [1]. Users of menopausal hormone therapy (MHT) have a two- to four-fold increased risk of VTE compared with non-users [2], comparable to the attributable risk of CHC. The risk for VTE induced by MHT is, however, higher in absolute figures because of the age factor per se, but is also dependent on the composition of the MHT used, since users of estrogen-only preparations have lower risk of VTE than women receiving combined estrogen-progestin preparations [3]. Also the dose and route of administration seems of importance, as women treated with transdermal MHT have lower risk of VTE than women receiving orally administered MHT, as consistently demonstrated in clinical studies [2]. Moreover, epidemiological and pharmacological factors may contribute to the precipitation of VTE among MHT users. The pharmacodynamics of MHT on the hemostatic system may be of particular interest [4], because MHT changes the inhibitory potential of coagulation significantly. Consequently, the choice of MHT may translate into clinical manifestations in thrombosis-prone individuals. Venous thrombosis mostly manifests in the deep veins of the leg, but may occur in other sites, such as the upper extremities, cerebral sinus, liver and portal veins or retinal veins. Major complications of VTE are a disabling postthrombotic syndrome or acute death from a pulmonary embolus (PE) occurring in 1–2 per cent of patients [5].
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- Information
- Managing the Menopause , pp. 223 - 233Publisher: Cambridge University PressPrint publication year: 2020