Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

CVD & Ca Risk in Women Using Vaginal Estrogen

Menopause; ePub 2017 Aug 14; Crandall, et al

Among postmenopausal women using vaginal estrogens, the risk of cardiovascular disease (CVD) and cancer were not elevated, a recent study found. The prospective observational cohort study included 45,663 participants (aged 50 to 79 years at baseline) from the Women’s Health Initiative Observational Study who did not use systemic estrogen therapy during 7.2 years’ follow-up. Data were analyzed on incident coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, death, and self-reported use of vaginal estrogen. Researchers found:

  • The risk of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonary embolism/deep vein thrombosis were not significantly different between vaginal estrogen users and nonusers.
  • However, the risk of CHD, fracture, all-cause mortality, and global index event (GIE) were lower in users than in nonusers (GIE adjusted HR, 0.68).
  • Among women who had a hysterectomy, the risk of each individual GIE components and of the overall GIE were not significantly different in users vs nonusers.


Crandall CJ, Hovey KM, Andrews CA, et al. Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women’s Health Initiative Observational Study. [Published online ahead of print August 14, 2017]. Menopause. doi:10.1097/GME.0000000000000956.

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