Overview

• Using national registries, researchers analyzed 34,274 women aged 45 or older after a first ischemic stroke (2008–2017), matching 3,353 with a recurrent stroke to 3,353 controls.
• There was no significant association between a second stroke and current, recent, or past use of vaginal estradiol tablets, including by dose or total cumulative exposure.
• The findings, published Aug. 21 in Stroke, extend prior evidence from healthy populations to women with a history of stroke.
• Authors and outside experts note limits such as prescription-fill data that do not confirm use, potential healthier-user bias, and results confined to tablet formulations.
• Clinicians and researchers say the data strengthen calls to remove the FDA boxed warning for low‑dose vaginal estrogen, though any change would depend on formal regulatory action.