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Safety of Vaginal Estrogen

15 February 2018

Menopausal effects of estrogen lack on the vagina and bladder affect many women and can cause significant discomfort, distress and even relationship problems. The use of vaginal estrogen is very effective and NICE and national and international guidelines recommend long term treatment. However, for some, concern has existed around the possible stimulatory effect of vaginal estrogen on the womb lining (endometrium) and hence risk of endometrial cancer, and data from previous trials have only assessed safety up to one year of use.

A review of recently published studies of long term use of vaginal estrogen has concluded that the bulk of evidence on use of low dose vaginal estrogen supports the safety of vaginal estrogen and no increase in the risk of endometrial cancer. Systemic absorption of vaginal estrogen is minimal and the effect is a local vaginal effect.

Estrogen lack affecting the vagina and bladder, known as Genitourinary Syndrome of the Menopause (GSM), is an important aspect of menopause which should be actively enquired about and effective treatment should be offered. This review provides more evidence of safety of vaginal estrogen.


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