Medical Q&As

HRT suitable - history of DVT?

Can you tell me if it is safe for someone who has had a DVT to take hormone replacement treatment by non oral methods such as the patch?

Several studies have shown that HRT (hormone replacement treatment) may marginally increase the risk of DVT (deep venous thrombosis or clot in the leg). It has also been shown that the risk remains the same irrespective of the type or strength of HRT, which answers your particular question about patch treatments. However, a single episode of DVT as a result of pregnancy, surgery or prolonged immobility is not a contraindication to using HRT. If that scenario does not apply and the woman has experienced a DVT for no apparent reason then she should be screened for possible clotting defects before commencing HRT. In that case the risk of DVT needs to be weighed in the balance against the benefits to the patient. If on the other hand if there is a history of repeated DVT or a permanent increased risk of DVT then HRT should be avoided. Therefore the crucial issue in deciding on a woman’s suitability for HRT is establishing the circumstances under which the clot occurred. Was it because of a particular situation that created an increased risk of DVT such as surgery or prolonged immobility or did it happen for no apparent reason? A history of DVT is not necessarily a contraindication to having HRT in either the form of a tablet or a patch.