The weakness of this study is that it is a single center study and therefore, may not reflect the true safety picture of the use of intravaginal estrogen. Since it is a single blinded study, it would have been more stronger and reliable if it would have been double blinded. There can be individual variations in the assessment by different consultants. This will introduce a bias in the study results.
The results of this study will have wider applications as it will provide a long term follow up of patients using intravaginal estrogen. There is a dire need of such studies to establish the safety profile of estrogen hormone replacement therapy as only a few studies provide results of long term use of intravaginal estrogen HRT.
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