Study Highlights Increased Risks of Oral Hormone Therapy for Women with Type 2 Diabetes
A recent study emphasizes the increased cardiovascular risks linked to oral hormone replacement therapy in women with type 2 diabetes, highlighting transdermal options as safer alternatives.
Recent research presented at the European Association for the Study of Diabetes (EASD) meeting in Vienna has shed light on the potential cardiovascular risks associated with hormone replacement therapy (HRT) in women with type 2 diabetes (T2D). While skin patch HRT was not linked to a higher risk of blood clots or stroke, oral HRT was associated with significant concerns.
In women with T2D, those using oral HRT showed a doubled risk of developing a pulmonary embolism (PE)—a dangerous blood clot in the lungs—and faced a 21% increased chance of heart disease compared to women using transdermal (skin patch) HRT. Conversely, transdermal HRT did not demonstrate an increased risk for PE, stroke, or cancers related to estrogen.
The study analyzed electronic health records from the TriNetX database, including 36,855 women aged around 59 years, who initiated HRT or statins between 2000 and 2020, with five years of follow-up. The data revealed that women with T2D on HRT, particularly oral formulations, faced higher risks of deep vein thrombosis (DVT), stroke, and cardiovascular disease.
Researchers emphasized that the increased risks observed with oral HRT might stem from how estrogen is processed in the body. Oral estrogen undergoes extensive liver metabolism, potentially disrupting the balance of clotting factors, whereas skin patches deliver estrogen directly, with lower doses.
Lead researcher Dr. Matthew Anson noted, "Our findings suggest transdermal HRT appears safer for women with T2D, and oral estrogen therapy should be prescribed with caution." Given these findings, healthcare providers are encouraged to consider the route of HRT administration carefully, especially for women managing T2D.
Despite the valuable insights, the study's retrospective nature means other unmeasured factors could influence the results. The majority of participants were white women, which may limit applicability across diverse populations. Further research is essential, but these results offer important guidance for clinical decision-making in menopause management for women with T2D.
For now, women with T2D and menopausal symptoms should consult their healthcare providers about the safest HRT options tailored to their individual health profiles.
(Source: https://medicalxpress.com/news/2025-09-women-diabetes-oral-hormone-therapy.html)
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