Hormones and blood thinners

[Ejo]

Does anyone take estrogen (patches) and spironolactone together with a blood thinner such as Eliquis?

My hematologist says that I won't get any blood clots if I take the Eliquis.

Anyone out there experiencing something similar?

I am skeptical and just plain scarred about resuming HRT since I had a blood clot on my calf recently, so I went to a hematologist who prescribed me the Eliquis and said that as long as I take Eliquis my clot will go away (which it has) and I don't have to worry about any future clots by resuming my HRT. Prior to this I was not on a blood thinner.

Any help would be great!

[AnonyMs]

What kind of HRT were you taking? Some forms have a much higher risk of causing blood clots.

[Dena]

I am not an expert on this but my understanding is when you are on a blood thinner you receive regular checks to monitor your clotting factor. As long as you are in the normal range, I would think you have no more risk than the average person of developing a clot and probably less risk. On the other hand Patches are supposed to have less risk than pills so you are on a safer delivery system.

[warlockmaker]

Many people take blood thinners for various medical reasons. I have been on HRT for over 5 years, pre and post op and  I take blood thinners, plain simple mini heart aspirins that you can buy anywhere.. My endo recommended this. This is typically recommended for older transitioners..

* Edited by Susan for TOS 2.

[JessicaSondelli]

Same here. I take a baby aspirin every day as recommended by my Endo.


Sent from my iPad using Tapatalk

[KayXo]

One study showed that patches (higher than typical dose) administered in transgendered women, of whom a few were predisposed to developing clots, did not lead to any incidences. They weren't taking any blood thinners, as far as I know.

Another study, in men with prostate cancer, aged 49-91 yrs old, had them on patches (with levels in the 400-600 pg/ml range) and yet, not only did the researchers observe no clot incidences but a reduction in risk based on blood meaurements, concluding that taking bio-identical estradiol this way might protect against the risk of deep vein thrombosis.

Estradiol taken transdermally mimics the way in which women get their estradiol naturally and we know that during pregnancy, when levels of estradiol reach levels as high as 75,000 pg/ml, the risk of DVT remains low, at 0.1%.

So, you should be fine. The risk of clots from transdermal delivery of bio-identical estradiol appears to be negligible.

If estradiol were so dangerous, then all ciswomen should be taking blood thinners. Doctors and the public at large often confuse estrogens, put them all in the same category and generalize findings from other types of estrogen to estradiol.

[Ejo]

Thanks to all of you that replied! I am beginning to wonder if the DVT was not related to the hormones, but to a past injury or something. My endocrinologist told me that I "should" be ok if I resume HRT with blood thinners but I told him that I needed a more reassuring answer because after all, my life could depend on it, so he was going to discuss my case with the hematologist and I am currently awaiting to hear back from him. By the way, I was on transdermal estradiol and spironolactone. I began noticing changes to my body after 3-4 weeks, so the dosage seems to have been right. Too bad about the DVT. Wish me luck!

[VivianJane]

Hey, I am on patches and I was on spiro before surgery a month ago.
I also was taking low does aspirin 80mg once daily.
Never had any problems.

[Sarah_Evelyn]

Ejo,
I can give you my story and experience on this subject. I saw a new general practicing doctor that was more than willing to prescribe HRT until.......  I gave her my medical history at our initial visit. I had previous episodes of superficial blood clots and had an MRI performed and they found that at some point in my life I could have had a DVT. Well the news of a possible DVT caused my Hematologist at the time to put me on Xarelto. I did well on it with no side effects. After analyzing my history with no underlying causes and gallons of blood tested my VA doc and I came to the conclusion that Xarelto may be a little much. We think what caused my previous clots was from heavy smoking back then. After quitting smoking and still not on thinners had zero incidences.

That new Doctor being scared, referred me to an endo. Saw the Endo, she was awesome agreed transdermal was the way to go and relatively safe. As always, here's the BUT... I also have had migrianes with auras and she was worried new studies are showing stroke risks with estrogen in people that get migraines with aura. The treatment to prevent stroke is blood thinners. So hmmm 2 birds with one stone. She wants me to see hematology and let them go over my case and see if i should go back on xarelto before estrogen. I don't care if I have to go back on xarelto to get E.
The issue with blood thinners prescribed together with estrogen was nothing more than there were no studies of interactions between the 2. That's why Drs were afraid in general to prescribe them together.
Lucky for us a study was done recently and Dr's are getting on board.

Heres a link that talks about the study.
Women can take blood thinners, hormones without higher blood clot, bleeding risk, study shows https://www.sciencedaily.com/releases/2015/12/151222112950.htm

[KayXo]

I also have had migrianes with auras and she was worried new studies are showing stroke risks with estrogen in people that get migraines with aura.

The estrogen in question is ethinyl estradiol, the one contained in the Pill with a profile that differs markedly from what we take, bio-identical estrogen especially considering that contraceptive pills also contain progestins that we don't take unless your doctor has you taking medroxyprogesterone acetate. Ethinyl estradiol and some of these progestins are known to have significant adverse effects on blood pressure, vascular incidence, clots, etc. It's important when looking at a study to distinguish between the different forms of estrogens and progestogens and also the route of administration. Bio-identical estrogen is quite safe, more so if taken non-orally. Transdermal E has been shown to be relatively safe in older folks even at high doses and even in predisposed individuals. PM me and I will share these studies with you, your doctors may be unaware of them.

Tobacco smoking can indeed increase the risk of a migraine with aura.

Migraines, without aura (I realize this is not your case), actually IMPROVE during pregnancy, when estradiol and progesterone levels are sky high, up to 75,000 pg/ml and 300 ng/ml, respectively. They tend to occur at the end of a cycle, when hormone levels DROP.

This is the reason I always double check what doctors and health professionals assert. I, myself, am not a doctor.

Heres a link that talks about the study.
Women can take blood thinners, hormones without higher blood clot, bleeding risk, study shows https://www.sciencedaily.com/releases/2015/12/151222112950.htm

Notice how all types of estrogens and progestogens were grouped together regardless of molecular structure and route of administration .

Thanks to all of you that replied! I am beginning to wonder if the DVT was not related to the hormones, but to a past injury or something.

Very possible. My dad got a clot after his tendon Achilles injury, after his surgical intervention.