The Safety of Oral Versus Transdermal Estrogen

Denise Black, MD, FRCSC


Menopause. 2020;27(11):1328-1329. 

In This Article

Women at Increased Risk of Stroke

Traditional risk factors for stroke include age, hypertension, diabetes, and hyperlipidemia. Alterations in coagulation, particularly with thrombin generation, may confer additional risk in postmenopausal women. Women with an elevated risk of stroke show no additional risk with low-dose transdermal estrogen exposure, whereas there appears to be a dose-related increase with use of oral estrogens. There may also be increased risk conferred by certain classes of progestogens, with norpregnane progestogens showing an increased ischemic stroke risk, based on observational evidence.[4]