BLOOD CLOTS and ESTROGEN: The Facts
How Real is the Risk?
If you haven’t already learned the “dangers” of estrogen from a helpful friend, social media influencer or even a doctor, just read the fine print on all estrogen product inserts to convince you that it is not worth getting a heart attack, blood clots, a stroke, cancer, and dementia to get rid of hot flashes or have a decent sex life. But of all the risks listed on the insert, which is the one that scares off the most women? And which are true?
Last year, I surveyed 500 women who chose not to take post menopause estrogen specifically because they perceived it to be dangerous. When asked which estrogen risk they were most concerned about,
70% checked “breast cancer”
20% checked “blood clot”
10% checked “heart disease”
I wasn’t surprised that most women think the most significant risk of taking hormone therapy is breast cancer, a myth that no matter how many times I debunk, crops up every day.
The correct answer is “blood clot.” But in most cases, it is only women with a history of blood clots who are made aware of the risk when they are told that hormone therapy is not an option.
So, how real is the risk?
A deep vein thrombosis (DVT) is a blood clot that forms in a leg, thigh, or pelvic vein. Some people have no symptoms, but in most cases, there is at least some pain, redness, and/or swelling in the leg or thigh. The danger of a DVT is that it can break off and travel to the lungs, resulting in a pulmonary embolism, which is potentially fatal. There are an estimated 100,000 deaths in the United States each year due to a DVT.
Putting aside estrogen for the moment, more than 80% of people who develop a DVT have at least one, and often more than one, risk. But 20% of people have no risk factors. Anyone can get a blood clot.
Anything that immobilizes you for long periods can cause blood to pool in your legs and increase the risk of clot formation. Truck drivers and people on long flights (especially if you are jammed into a coach seat) fall into this category.
Some people, especially those who develop multiple DVTs, are genetically programmed to form blood clots more easily. So if you have a history of multiple blood clots or it seems like a lot of family members have had strokes, DVTs, or pulmonary embolisms, it’s worth getting tested to see if you have an inherited thrombophilia such as Factor V Leiden deficiency.