Estrogen

June 5, 2023 – Women who take estrogen-only pills to manage menopause symptoms are more likely to be diagnosed with high blood pressure, compared to women using estrogen-only patches or creams, according to a new study.

Researchers at the University of Calgary looked at the medical records of about 112,000 women 45 and older who had been prescribed at least 6 months of different kinds of estrogen-only hormone treatment between 2008 and 2019. Then, the research team tracked the medical records to see who developed high blood pressure – also known as hypertension – at least a year after treatment.

Women taking the pills had a 14% higher chance of high blood pressure, compared to women using skin patches, the study, published in in the journal Hypertension, showed. Women taking the pills had a 19% higher risk than women using estrogen-only vaginal creams or suppositories.

Women are prescribed estrogen at a hormone replacement therapy (HRT) during menopause because estrogen levels fall, sometimes causing hot flashes, vaginal dryness, and other symptoms.

HRT can be given as estrogen only, progesterone only, or estrogen and progesterone together. The mixture usually uses progestin, a synthetic version of progesterone.

"This is the biggest study that's only looked at women who are only taking estrogen and have never taken a progestin as HRT," study author Sofia Ahmed, MD, a professor at the Cumming School of Medicine at the University of Calgary, told CNN.

For women taking oral estrogen, the risk of high blood pressure increased as the dosage and length of time taking the drug increased, Ahmed said.

SOURCES:

Hypertension: "Association Between the Route of Administration and Formulation of Estrogen Therapy and Hypertension Risk in Postmenopausal Women: A Prospective Population-Based Study."

CNN: "Oral estrogen-only use riskier than patch or vaginal cream for menopausal women, study says."