A study published in Menopause found no increased risk of cardiovascular disease and cancer among postmenopausal women who have been using vaginal estrogen therapy vs. those who have not been using any estrogen.
Previous studies and randomized trials have shown women who take oral estrogen therapy may have a higher risk of blood clots, stroke, and invasive breast cancer (when taken with progestogen pills). For women who take vaginal estrogen therapy, it is unclear whether this route of therapy also holds similar risks as the pill form.
Study authors analyzed patient data from the Women’s Health Initiative Observational Study across 40 centers for women aged 50–79 years. The data showed women with an intact uterus did not have a significantly different risk of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonary embolism/deep vein thrombosis (PE/DVT) between those who used vaginal estrogen and those who did not.
Women who use vaginal estrogen therapy had a lower risk of coronary heart disease, fracture, and premature death vs. women who did not use vaginal estrogen therapy. In addition, the risks of coronary heart disease, stroke, cancer, and PE/DVT for women who had hysterectomies did not significantly differ between vaginal estrogen users vs. non-users.
Findings from this study suggest that vaginal estrogen therapy is safe for symptomatic relief associated with menopause such as burning, discomfort, and dyspareunia.
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