A systematic review including 12 studies with a total of 214 subjects was abstracted in DARE. The participants used 0.5 mg of estriol cream or suppository once a day for two or three weeks, followed by a gradual reduction to 0.5 mg twice per week. All 337 post-baseline endometrial biopsies were classified as atrophic by the authors of the primary studies. These included 61 biopsies at 6 months after the commencement of treatment and 58 at one year.
Comment: The quality of evidence is downgraded by imprecise results (few patients with long-term follow-up).