Transdermal and oral hormone replacement therapy and the risk of stroke: a nested case-control study

Conclusions The use of transdermal HRT containing low doses of oestrogen does not seem to increase the risk of stroke. The presence of residual confounding, however, cannot be entirely excluded in the interpretation of this finding.

(Promestriene) Urogenital disorders associated with oestrogen deficiency: the role of promestriene as topical oestrogen therapy; Gynecological Endocrinology

"Given the absence of systemic activity, promestriene may be a good choice in women requiring purely locally oestrogen, and those who have survived, or who are at risk of breast cancer and who have severe vulvo-vaginal symptoms."