If you use a patch or gel for estrogen instead of a pill, and pair it with a specific type of progesterone, you’re not more likely to get dangerous blood clots — but if you take estrogen as a pill with any progesterone, your risk of blood clots doubles compared to not taking any hormones at all.

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Evidence from Studies

Supporting (1)

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Estradiol and Micronized Progesterone: A Narrative Review About Their Use as Hormone Replacement Therapy

Narrative Review

2025 Oct 16

This study says that when women use estrogen through the skin (not pills) with a natural form of progesterone, it doesn’t raise the risk of dangerous blood clots — unlike oral estrogen, which does. So the way you take estrogen matters for safety.

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No contradicting evidence found

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Source Study

Estradiol and Micronized Progesterone: A Narrative Review About Their Use as Hormone Replacement Therapy

Score: 1

DOI: 10.3390/jcm14207328

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