Is Vaginal Estradiol Safe for Women with Prior Ischemic Stroke?

Local vaginal estrogen therapy is not associated with increased risk of ischemic stroke in healthy postmenopausal women. However, its safety among women at high risk for recurrent ischemic stroke has not been well studied. Now, researchers have used national health registry data in Denmark to evaluate the safety of vaginal estradiol tablets among women who had experienced a first ischemic stroke at age 45 and older and had not used systemic or vaginal menopausal hormone therapy prior to that. The analysis included 3300 women who developed recurrent ischemic stroke (cases) and 3300 women who did not (matched controls).