ArticleMenopause (New York, N.Y.)2018
Vaginal estrogen use and chronic disease risk in the Nurses' Health Study.
Article in Menopause (New York, N.Y.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.Rheumatology (Oxford, England) · 2025Guideline
- Measuring serum oestrogen levels in breast cancer survivors using vaginal oestrogens: a systematic review.Breast cancer research and treatment · 2024Pooled it
- A systematic review and meta-analysis of effects of menopausal hormone therapy on cardiovascular diseases.Scientific reports · 2020Pooled it
- Endometrial safety of low-dose vaginal estrogens in menopausal women: a systematic evidence review.Menopause (New York, N.Y.) · 2019Pooled it
- Association of Vaginal Estradiol Tablet With Serum Estrogen Levels in Women Who Are Postmenopausal: Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2022Trial
- Report of the FDA's expert panel on hormone therapy.Menopause (New York, N.Y.) · 2026Review
- Establishment of harmonized international reference ranges for plasma estradiol concentrations in postmenopausal women.The Journal of clinical endocrinology and metabolism · 2026Article
- Efficacy and Safety of Radiofrequency as a Treatment Modality for Genitourinary Syndrome of Menopause: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.International urogynecology journal · 2026Review
- Does the Addition of Vaginal Oestrogen to Anticholinergic Medication Improve Overactive Bladder Symptoms? A Systematic Review and Meta-Analysis.International urogynecology journal · 2026Review
- Case-Based Perspectives on the Management of Genitourinary Syndrome of Menopause.Clinics and practice · 2026Review
- Treating Genitourinary Syndrome of Menopause in Postmenopausal Women with a History of Breast Cancer.Drugs & aging · 2026Review
- Article
- [Russian eligibility criteria for prescription of menopausal hormone therapy to patients with cardiovascular and metabolic diseases. Agreement document of RKO, ROAG, RAE, EAT, AFR, RNMOT, RAGG].Problemy endokrinologii · 2026Article
- Urinary manifestations of genitourinary syndrome of menopause: a review of the pathophysiology, clinical presentation, and management.Gynecology and pelvic medicine · 2026Review
- Genitourinary syndrome of menopause.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Analyzing google search trends for "vaginal estrogen" and its relationship to medical recommendations for post-menopausal women.International journal of impotence research · 2025Review
- Genitourinary symptoms in women with breast cancer: frequency, severity and impact.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Innovative Drug Delivery Systems for Management of Menopausal Symptoms: A Systematic Review.International journal of women's health · 2025Review
- Investigation ofFrontiers in pharmacology · 2025Article
- Association of vaginal oestradiol and the rate of breast cancer in Denmark: registry based, case-control study, nested in a nationwide cohort.BMJ medicine · 2024Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo examine the associations between vaginal estrogen use and multiple health outcomes including cardiovascular disease (total myocardial infarction, stroke, and pulmonary embolism/deep vein thrombosis), cancer (total invasive, breast, endometrial, ovarian, and colorectal cancer), and hip fracture.
methodsWe included postmenopausal women from the Nurses' Health Study (1982-2012) who were not current users of systemic hormone therapy at the start of the study or during follow-up. Vaginal estrogen use was self-reported on the biennial questionnaires. Information on incident health outcomes were self-reported and confirmed by medical records. We used Cox proportional hazards regression to model the multivariable adjusted hazard ratios and the 95% confidence intervals for vaginal estrogen use and multiple health outcomes.
resultsOver 18 years of follow-up, after adjusting for covariates, risks for cardiovascular disease, cancer, and hip fracture were not different between users and nonusers of vaginal estrogen. No statistically significant increase in risk of any health outcome was observed with vaginal estrogen use. In sensitivity analyses, when we examined associations by hysterectomy status, the stratified results were generally similar to those for the total cohort.
conclusionsVaginal estrogen use was not associated with a higher risk of cardiovascular disease or cancer. Our findings lend support to the safety of vaginal estrogen use, a highly effective treatment for genitourinary syndrome of menopause.
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