Continued resistance to the use of hormone replacement therapy in menopausal women persists, in part because of concern over a possible relationship between estrogen use and venous thromboembolism. Numerous studies, both retro- and prospective, have failed to yield any evidence of increased relative risk for thrombosis: specific investigations have consistently failed to link estrogen use to clinically significant adverse changes in coagulation factors. We feel that any linkage of menopausal estrogen use and risk of venous thromboembolism is based on anecdotal comments and medical superstition.