Which method of administering combined estrogen and progesterone therapy has the highest risk of deep vein thrombosis (DVT)?

• A. Oral route
• B. Transdermal patch
• C. Intravaginal cream
• D. Intravaginal ring

Answer: (A)

The oral route of administering combined estrogen and progesterone therapy carries the highest risk of deep vein thrombosis (DVT) due to the way the body metabolizes these hormones. When estrogen is taken orally, it undergoes first-pass metabolism in the liver, which can lead to increased levels of clotting factors and a higher concentration of hormones in the bloodstream. This alteration in the coagulation system can predispose individuals to thrombotic events such as DVT.

In contrast, other routes of administration like transdermal patches, intravaginal creams, and intravaginal rings bypass the first-pass metabolism, leading to more stable hormone levels in circulation. This results in a reduced impact on the coagulation factors and a lower risk of thrombosis. Therefore, the oral administration method stands out as having a significantly heightened risk for DVT compared to the other listed methods.