A reader commented that our recent article on treatment of menopausal symptoms (Med Lett Drugs Ther 2012; 54:41) should have mentioned the potential advantages of transdermal estrogen. Transdermal estrogens are probably as effective as oral estrogens in treating vasomotor menopausal symptoms, but transdermal administration may have less effect on serum triglycerides, C-reactive protein, thyroxine-binding globulin, cortisol-binding globulin and sex hormone-binding globulin. Observational data suggest that the risk of venous thromboembolism may be lower with transdermal administration compared to standard-dose oral estrogens, but comparative randomized controlled trials are lacking.