Another Trial Suggests the Safety of Short-Term Estrogen-Only Therapy

Investigations of the cardiovascular safety of estrogen-only menopausal therapy typically have excluded women with an intact uterus because of concerns about endometrial cancer. To determine if unopposed estrogen lowered long-term risk for reinfarction or death in myocardial infarction (MI) survivors, investigators conducted extended follow-up in a U.K. trial involving 1017 postmenopausal women (age range, 50–69) with an intact uterus who were recruited at the time of their first MI. Participants were randomized to receive 2-mg estradiol valerate or placebo daily for 2 years, and were closely monitored for episodes of vaginal bleeding. All women who experienced such bleeding during the intervention received active management.

During a mean f…