Prevention

There is no clear benefit from hormone replacement therapy ^a

Why?

• Postmenopausal women who take estradial compared with placebo are not clearly less likely to have another stroke or die, but were more likely to develop vaginal bleeding or endometrial hyperplasia. ^a

Estradiol increases vaginal bleeding and endometrial hyperplasia

Patient a	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNH (95% CI)
postmenopausal women with a previous stroke or TIA	estradiol	placebo	vaginal bleeding at 12 months	11%	-240% (-380% to -140%)	4 (3 to 6)
			endometrial hyperplasia at 12 months	0.9%	-1000% (-3400% to -240%)	11 (8 to 17)