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A new study suggests that menopausal women who take hormone replacement therapy (HRT) in the form of skin patches may be significantly less likely to develop blood clots than those who take it in tablet form.

Researchers found that HRT given orally more than doubles the risk of blood clots, according to a report in the British Medical Journal.

Data from eight observational studies and nine randomised controlled trials found that women taking the oral form of the therapy were between two and three times more likely to develop a blood clot.

The study also revealed that the risk is much higher during the first year of treatment, and in women who are overweight or genetically prone to blood clots.

In contrast, HRT patches did not appear to increase the risk of blood clots, perhaps because of the different way in which oestrogen is absorbed into the bloodstream.

In an accompanying editorial, Helen Roberts from the University of Auckland calls for more research to confirm the apparent safety of oestrogen patches.

'In the meantime, we can advise healthy menopausal women, aged 50 to 59, that the risk of [blood clots] with oral preparations is 11 additional cases per 10,000 women per year for combined therapy and two additional cases per 10,000 women per year for oestrogen only,' she said.

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