Compared with oral formulations, transdermal and intranasal forms of postmenopausal hormone therapy (HT) produce substantially smaller changes, if any, in levels of the cardiovascular risk markers, C-reactive protein (CRP) and activated protein C (APCr), suggesting that they pose less of a threat of atherosclerotic and venous thromboembolic disease.
The finding comes from a systematic review of 72 randomized clinical trials. The authors of the review also noted that changes in cell adhesion molecules and some fibrinolytic parameters tended to be smaller with non-oral treatment than with oral HT, whereas changes in lipoprotein(a) and homocysteine did not differ between oral and non-oral forms of therapy. There were also minor or no differences between formulations in their effect on coagulation parameters.
Hemelaar M, van der Mooren MJ, Rad M, et al. Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: a systematic review. Fertil Steril. 2008;90:642-668.