• J Fam Pract · Nov 2023

    Meta Analysis

    Does vaginal estrogen use increase the risk for adverse cardiovascular outcomes?

    • Jacqueline Hendrix, Ethan Chang, Vivian Cheng, Jon O Neher, and Sarah Safranek.
    • Valley Family Medicine, Renton, WA.
    • J Fam Pract. 2023 Nov 1; 72 (9): 389393389-393.

    AbstractNO. In general, nonoral estrogen use for menopausal symptoms is associated with a lower cardiovascular (CV) risk profile than oral estrogen use (strength of recommendation [SOR], B; meta-analysis of cohort studies). Vaginal estrogen use is associated with lower risk for coronary heart disease (CHD) and similar risk for myocardial infarction (MI), stroke, and deep vein thrombosis/pulmonary embolism (DVT/ PE) compared with nonuse (SOR, B; cohort studies). Vaginal estrogen therapy also is associated with lower CV-related mortality for 3 to 5 years compared withnonuse (SOR, B; cohort study). No high-quality randomized trials address this topic.

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