Female Hormones And Vascular Disease

There’s good news and bad news surrounding birth control pills and hormone replacement therapy. While one new study reinforces previous findings that estrogen and progesterone hormones together increase blood clot risk, another shows birth control pills actually reduce the risk of cardiovascular disease.

A study earlier this month in the journal of the American Medical Association showed that women who take the hormone therapy estrogen and progesterone have double the risk for blood clots in the veins. But the new research shows in the arteries, birth control pills can prevent blockages.

I am very well aware of the risks. There are no risk factors in my family in terms of stroke or blood clots. My mom lived until almost 90. Barbara Isaac is a nurse and made an educated decision to continue to use hormone replacement therapy, or HRT, in spite of the now well-documented risks. But she is slowly having her dose lowered as time goes on. Probably in the next couple of years go off them. "Hopefully hot flashes won’t return and that my bone density won’t suffer terribly", says Barbara.

New research recently released shows certain types of hrt can double a postmenopausal woman’s chances of developing blood clots in the leg veins, which can break off, travel to the lungs, and potentially kill. The findings continue the stream of bad news about estrogen which has led to a sharp drop in the sales of hormone replacement therapy. The blood clot risk was nearly four times higher in overweight women, and more than five times higher in obese women.

But other research just presented shows birth control pills reduce the risk of heart attacks and other forms of cardiovascular disease including high blood pressure, strokes, and high cholesterol diseases of the arteries, not veins. The pill reduced the need for surgical procedures, including bypass surgery and angiograms significantly. The difference between the pill and HRT probably has to do with the fact that different types of estrogen are used. Still, experts say, "if you’re considering hormones of any type, use caution".

The researchers say the findings suggest that overweight or older women who use oral contraceptives or hormone replacement therapy should be vigilant about looking for the signs and symptoms of blood clots, which include pain and swelling in the leg. Nanette Santoro, Director of Reproductive Endocrinology at Albert Einstein College of Medicine and Montefiore Medical Center, says, "People who have family histories with many family members or one than one family member whose been affected by a clot with no reason, those people should be tested. They are they group that have the excessive amount of risk for which these hormones aren’t safe". A separate study found no increased clot risk among women taking estrogen only pills.