Exposure to vaginal estradiol not linked to increased rate of recurrent ischemic stroke when adjusted for comorbidity, medications, income, education
By Elana Gotkine HealthDay Reporter
THURSDAY, Aug. 21, 2025 (HealthDay News) — For women with a history of ischemic stroke, use of vaginal estradiol tablets is not associated with an increased rate of recurrent stroke, according to a study published online Aug. 21 in Stroke.
Kimia Ghias Haddadan, M.D., from Copenhagen University Hospital-Herlev and Gentofte in Denmark, and colleagues conducted a nationwide nested case-control study involving all women aged 45 years and older who developed a first ischemic stroke between Jan. 1, 2008, and Dec. 31, 2017, and had no history of vaginal estrogen use before stroke. Cases with recurrent ischemic stroke were matched in a 1:1 ratio to controls based on birth year. Exposure to vaginal estradiol tablets was assessed using prescription data and classified as current use, recent use, and past use (zero to three, three to 24, and >24 months before index [date of recurrent stroke diagnosis], respectively).
A total of 3,353 recurrent cases were identified from a cohort of 56,642 women with a first-time stroke and were matched with 3,353 controls. The researchers found that exposure to vaginal estradiol tablets was not associated with an increased rate of recurrent ischemic stroke after adjustment for comorbidity, medications, income, and education.
“We were cautiously hopeful about the findings, and it was reassuring to discover that the use of vaginal estrogen did not raise the risk of recurrent stroke in this high-risk population,” Haddadan said in a statement. “U.S.-based studies, such as the Women’s Health Initiative and the Nurses’ Health Study, have shown no increased stroke risk with vaginal estrogen in healthy women. Our study extends this reassurance to women with a history of stroke.”
Several authors disclosed ties to the biopharmaceutical industry.
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