The Menopause, Estrogen and Venous Events (MEVE) study was a retrospectiveobservational study of menopausal hormone therapy and venous thromboembolism (VTE) in postmenopausal women with a previous history of VTE.[1][2][3][4][5] It found that transdermalestradiol was not associated with increased risk of VTE (HRTooltip hazard ratio = 1.0, 95% CITooltip confidence interval 0.4–2.4) whereas oralestrogens were associated with a large increase in risk (HR = 6.4, 95% CI 1.5–27.3).[1][3][4] The mean dose of transdermal estradiol in the study was 50 μg/day, although data on dose were missing for around 50% of women.[1][2] Similarly, a small study found that transdermal estradiol did not influence coagulation in women with prior VTE.[6] These findings are similar to studies in menopausal women without prior history of VTE which have found that transdermal estradiol has minimal influence on coagulation[7] and is not associated with increased risk of VTE at doses of up to 100 μg/day.[8][9][10][11] Menopausal hormone therapy guidelines have cited the MEVE study and recommended use of transdermal estradiol over oral estrogens in women at high risk for VTE.[12][13][14][15] However, randomized controlled trials (RCTs) are still needed to definitively confirm findings that transdermal estradiol is safer than oral estrogens in terms of VTE risk.[12][16][17]
^Rovinski D, Ramos RB, Fighera TM, Casanova GK, Spritzer PM (August 2018). "Risk of venous thromboembolism events in postmenopausal women using oral versus non-oral hormone therapy: A systematic review and meta-analysis". Thromb Res. 168: 83–95. doi:10.1016/j.thromres.2018.06.014. PMID29936403. S2CID49421543.
^Scarabin PY (August 2018). "Progestogens and venous thromboembolism in menopausal women: an updated oral versus transdermal estrogen meta-analysis". Climacteric. 21 (4): 341–345. doi:10.1080/13697137.2018.1446931. PMID29570359. S2CID4229701.
^Oliver-Williams C, Glisic M, Shahzad S, Brown E, Pellegrino Baena C, Chadni M, Chowdhury R, Franco OH, Muka T (March 2019). "The route of administration, timing, duration and dose of postmenopausal hormone therapy and cardiovascular outcomes in women: a systematic review". Hum Reprod Update. 25 (2): 257–271. doi:10.1093/humupd/dmy039. PMID30508190.
^Tremollieres F, Brincat M, Erel CT, Gambacciani M, Lambrinoudaki I, Moen MH, Schenck-Gustafsson K, Vujovic S, Rozenberg S, Rees M (June 2011). "EMAS position statement: Managing menopausal women with a personal or family history of VTE". Maturitas. 69 (2): 195–8. doi:10.1016/j.maturitas.2011.03.011. PMID21489728.