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All TopicsForum: Hormonal Therapy - Before, During and After → Topic: estrogen cream

Topic: estrogen cream

Forum: Hormonal Therapy - Before, During and After — Risks and benefits, side effects, and costs of anti-estrogen medications.

Posted on: Jun 26, 2007 05:10PM

dberg wrote:

Does anyone use Premarin vaginal cream? I about fell off my chair when my onc mentioned it after I complained about vaginal atrophy. My gyn wrote me a prescription for it today and said it isn't absorbed systemically. Hmmm, I just got done reading the insert from inside the box and it says not to use it if you have had bc.

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Jun 26, 2007 05:19PM Nan72 wrote:

Geez, my gyno told me something similar and I told him he better read up on the product before he just gives it to everyone. I told him I was not using it that is the reason I had surgeries to stop hormones being produced.
Sometimes docs don't pay attention as they should you have to be your own advocate.

Remember it's not how many breaths you take but how many moments take your breath away

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Jun 26, 2007 07:32PM Member_of_the_Club wrote:

I was given estrogen cream a year before my bc diagnosis for a skin condition. I quizzed the doctor, can this cause cancer. He said no. When I was diagnosed he told me to stop using it immediately. I completely believe the estrogen cream contributed to the growth of my cancer. I have since read that the cream can actually release quite a bit of estrogen into the bloodstream.

I have been told by several doctors that the estring is safer and while I believe them i don't trust that either.
Dx 9/30/2004, IDC, 3cm, Stage IIb, Grade 2, 1/17 nodes, ER+/PR+, HER2-
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Jun 26, 2007 09:54PM laureniris wrote:

My gyn-onc, who did ooph, is also a premarin fan (and well-known Ovarian Cancer specialist). I was referred to him cause I'm BRCA2+. He would like me to use just a little premarin, say, a large dab once a week, because he thinks I can LIMIT the amount more than an estring. My regular onc, for breast cancer, said it really is contraindicated with an AI, but would be ok with tamox. So, as I'm on an AI, I pretty much resist using the premarin(sometimes I use a miniscule dab if things are really dry). Susan Love in her book also suggests using small dabs. It's extremely confusing. Right now I'm intrigued by the idea of testosterone cream, as my testos. is extremely low and I have no libido. Does anyone use it?

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Jun 28, 2007 07:31PM volzlin wrote:

I just had this conversation with my onc. He said to try to the over the counter remeidies first, such as replens and astraglide (what a name). He would only recommend an estrogen cream if the others didn't help since it is really not known what effect they may have. Hope this helps.

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Jun 29, 2007 02:53PM DoreenF wrote:

I listened in to a conference call on this subject a couple of weeks ago for breast cancer suriviors - the speaker was a woman - Dr. Kamel - it was one of the ShareRing Calls Y-Me has. The subject was "Female health issues after breast cancer". Her message was to try the over the counter remedies: replens, astroglide, ky-Jelly, eros - but she didn't really expect that they would help. She said that the the use of Vagigem is safe in small doses - Here's a link to the Transcript from Y-Me

"Cancer May Leave Your Body, but It Never Leaves Your Life" - Lance Armstrong Foundation Manifesto.

Dx 4/18/2005, IDC, <1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+, HER2-
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Jun 29, 2007 07:58PM dberg wrote:

Thanks girls,
I am a little hesitant to use the stuff after all your replies. I'm 48, was dx at 45, and am suffering the after-effects of chemo induced menopause. My GYN told me I have the vagina of a 60-70 year old. No wonder sex hurts. I'm desperate for something that will make me feel like I use to, and have tried Astroglide, Replens and the rest. Maybe regularity has something to do with it?
Dx 6/30/2004, IDC, 5cm, Stage IIIa, Grade 3, 2/13 nodes, ER+/PR+, HER2+
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Jun 30, 2007 07:45AM Erica wrote:

dberg,

I use Vagifem, tiny estrogen tablets that are inserted twice a week. Like Estring, Vagifem is considered to cause minimal absorption into the bloodstream, much lower than estrogen creams. My onc is fine with my using this. Like you, I had bad vaginal atrophy. In addition to painful intercourse, I was getting urinary tract infections, so was constantly on antibiotics, which isn't a good thing. I tried every over-the-counter remedy--replens, astroglide, other lubricants--to no avail.For me, Vagifem has restored my sex life and my vaginal health, generally.


As far as warnings on the label, all products which contain any estrogen are required to say that they could cause bc.

BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree

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Jul 1, 2007 06:07PM AlaskaAngel wrote:

dberg

When my onc originally said I should take tamoxifen after doing chemo, I asked if it would result in vaginal dryness. He literally laughed at me and said no. Two weeks after starting tamo at age 51 I was painfully dry. (What do THEY know! It isn't their body.) I stopped using tamo for a bit but alas, nothing improved. I talked with my PCP about it, who had no answers. I then went back to my onc and his only reaction was "Why aren't you talking to your PCP about this?" (The rotten buck passer.) They aren't all heartless but all of the oncs I've seen so far, male or female, give this problem lip service after the fact, and never tell anyone about it ahead of time.

Am I bitter about it? YES. They should be up front about it. That is what "consent to treatment" is about.

My onc said I could try the Estring. I would bet that he only says that to those who are early stage, but that is just a bet. The package insert has the caution about breast cancer. I have used it for more than 3 years and am NED. It does nothing for libido. When used with other lubrication it makes it possible for me to have coitus but initially it is still painful and it is never a pleasure.

I briefly tried using compounded estriol cream by prescription from my OB-GYN instead, but inserting it was far too painful and bloody.

I participated in a small clinical trial (150 breast cancer survivors) for the use of testosterone to see if it helped with libido. The published results were "no". One caveat to that is that many women who use testosterone (not just woman who have had chemo), use it on the clitoris directly whereas the trial required that it not be used on the genitals but on other areas like the stomach.

Let us know how things turn out for you,

AlaskaAngel
Dx 12/3/2001, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2+Surgery 01/03/2002 Lumpectomy (Left); Lymph Node Removal: Sentinel Lymph Node Dissection (Left)
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Jul 4, 2007 09:28AM raven81 wrote:

I didn't use the cream, but last year my onc. told me it was okay to use e-string. He said it is absorbed locally and is such a small amount, it would be okay. I had had an ooph and was on Aromasin for about 6 months when this happened.

Well, a few months later, I saw my GYN onc and he said that e-string can be absorbed systemically and had my estroidal level tested. When I called for my results, the nurse said I "wasn't quite at menopause yet", my level being 38. WHAT??? I had no ovaries for a year and I'm taking an AI and I'm not in menopaue???

Well out with the e-string, back with the dryness. So please be careful with an estrogen based product. I think our bodies are so starved for estrogen they just soak it up.

Stay well,

Eileen

Live Simply, Love Generously, Care Deeply, Speak Kindly, Leave the rest to God

Dx 10/30/2003, IDC, 3cm, Stage IIIa, Grade 3, 7/20 nodes, ER+/PR+, HER2-
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Jul 15, 2007 02:09PM peachy49 wrote:

I had my hyst/ooph in June. I just saw the GYO last wk, guess what? He prescribes Premarin cream. I told him that I have BC and he said he knew and that its only absorbed locally. WRONG. I read the insert too, and it is absorbed systemically, even in small amts, its too much for me. The other side effects aren't all that great either. Whats a girl to do? I will need something, but dont know where to turn for answer. Onco isn't even giving me AI now due to allergies and liver problems. I am left wondering about the future.

Peace n' Prayers

¤PeachyMarie§¤ "If we have no peace, it is because we have forgotten that we belong to each other." Mother Teresa

Dx 8/31/2006, IDC, <1cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Jul 17, 2007 04:30PM Coltsneck wrote:

I am dealing with the same issue - I'm using replens and astroglide, but still not able to have full penetration. I started using replens every other day rather than every 3 days, hoping that the extra day will improve the situation. It's very discouraging to deal with this issue and even though my husband is very understanding, I know he misses the intimacy of the old days - i.e., last year. I was really shocked by how quickly and completely the vaginal dryness occurred. I had already been in menopause for 5 years and had some dryness, but nothing like this.
I don't think anyone is doing really dedicated research on this topic - it's not even discussed by many oncologists and it's embarrassing to have to raise the topic. All my hopes are riding on Replens. If anyone has other suggestions, please let me know.

Maureen
Dx 5/2/2006, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2-
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Jul 17, 2007 05:16PM 2angels wrote:

I was told I have the vagina of a 70 yr. old. Intercourse is so painful that it is impossible. I have so much atrophy that the ligaments are pushing through and the neck of my bladder is bulging into my vagina. I was at first told to try over the counter remedies and they did not work. I tried the estring with no luck. I was dx stage 3, had a complete hysterectomy and bagan femara. At first it was stay away from anything estrogen. Then with the estring, I was told it does not reach a level detectable in the blood. Since none of these worked my onc. then told me to use an estrogen cream (estrace). My husband is scared to death with me using it. Now my onc. says that there is no scientific results that using it will cause my cancer to return and that it is a quality of life issue. It is so tough. I don't want to do anything that will cause a recurrence. I had no idea what kind of long term side effects I was going to have from treatment. I started the estrogen cream and was told to do it 2-3 times a week for maintenance. I am praying I get some relief I don't want to use it but have not found anything else that has worked. I don't think anyone can know the problem this can cause for those of us surviving long after we go through treatment.
Ann
Dx 10/1/2003, IDC, 5cm, Stage IIIb, Grade 2, 12/14 nodes, ER+/PR-, HER2-
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Jul 18, 2007 07:34AM AnnBrown wrote:

Hi, Ann, another Ann here with similar problems. I am getting the premarin cream today after consultation with my onc and gyn. Of course, they both said to try everything else (I have tried so many lubricants plus Replens and Relagard -for vag pH). I am postmenopausal (chemopause when I was 45, age 48 now) and can't believe how many problems I am having. Painful intercourse, no libido, discharge, dryness, yuk. I rationalized it this way to my gyn: I am postmenopausal and on tamoxifen. If I were premenopausal, I would still be taking the exact same dose of tamoxifen. You can't tell me the amount of estrogen in my body now is anywhere near the amount in a premenopausal woman. So, if the dose of tamoxifen I'm taking would be enough to block the estrogen receptors in a premenopausal woman, then why wouldn't it block the tiny amount that might get into my bloodstream while using the premarin cream? I told her I would only use it as short a time as I could to see if there is an improvement. It is definitely a quality of life issue. I'll let you know if it works in a few weeks.
Ann

PS. The Relagard did seem to help a little with pain, I guess from correcting the pH in my vag. It was VERY messy, though, and definitely do NOT try to use it after intercourse, even if it is a scheduled day. I read later that it contains acetic acid (vinegar, really) and it BURNS!!! Definitely made for some funny moments with my husband.
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Jul 20, 2007 11:09AM sandi05 wrote:

long time since I have posted but wanted to say I am on the cream, it is a hard decision...but after 6 UTI's this year, I had had enough..use the cream twice a week, oncol. said it was OK..no more UTI's so far..my hair is thinning, bone pain, ridges in nails, increased blood pressure, the UTI thing was pushing me over the edge..so I am using it..glad the problem is solved for now..I guess you just have to have that fight with yourself and decide how your quality of life is.then choose..sorry not much help but it is helping me..so far.. Sandi

cancer sucks

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Jul 20, 2007 11:20AM Pharmmom wrote:

I use Vagifem and I use a topical estadiol compound. I lately (this week) had to go up to 3x's for the vagifem. I am so dry and I hadnt been real faithful about using it. My husband and I had sex and I felt horrible the last few days. I used ky ovules, replens, and 3 vagifems over the course of the week also. I also took diflucan (3 of them during the course of the week). I have an appt with the gyno on Tuesday. This is all due to no ovaries and the AI's. But what can you do??? You have to be on them. A normal situation this is not and I am 43 years old. Some days I just get so disgusted with all of it.

Dx 10/11/2002, IDC, 1cm, Stage IIa, Grade 3, 3/17 nodes, ER+, HER2+
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Jul 20, 2007 11:23AM Pharmmom wrote:

OH and might I add having sex "regularly" I tried this, led to a UTI and a yeast infection. I miss the old days before all of this crap. Very hard on a marriage.

Dx 10/11/2002, IDC, 1cm, Stage IIa, Grade 3, 3/17 nodes, ER+, HER2+
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Jul 20, 2007 12:43PM ShirleyHughes wrote:

My onc emphatically told me no type estrogen cream. He said gyn's would tell me that it was okay. He says it isn't. I had five nodes positive AFTER chemo so I won't take a chance. However, I'm a bit older than some of you, 61.

God, grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference

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Jul 20, 2007 01:11PM Pharmmom wrote:

I felt like that too. Then my 'quality of life' started going down hill fast. My oncologist and I talked and he said they really don't know what will happen down the road. He did prescribe the Vagifem. I got BC at 38. He also talked about me and my quality of life. I have to tell you even with this stuff its not the same. Im always on edge that I will get a yeast infection or just the soreness. It stinks!

Dx 10/11/2002, IDC, 1cm, Stage IIa, Grade 3, 3/17 nodes, ER+, HER2+
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Jul 22, 2007 06:18AM peachy49 wrote:

I bought the Replens, but haven't used it yet. I wanted to know if it causes anymore problems than I already have. I am only 7 wks post hyst/ooph and I already have vag. pain. Of course the first intercourse didn't help. OUCH. Even with that Astroglide. And since hubby has prostate CA and is on Lupron, our sex life will be nil very soon.. We are both sad to lose such an intimacy after 30 yrs. Such is life.

Any feedback on the Replens, greatly appreciated.

¤PeachyMarie§¤ "If we have no peace, it is because we have forgotten that we belong to each other." Mother Teresa

Dx 8/31/2006, IDC, <1cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Jul 24, 2007 05:55AM esserbre wrote:

I have no luck with Replens, it "burns" too. KY doesn't really help totally. After intercourse this morning which was a little uncomfortable, urinating felt like someone was cutting me with a knife down there. Now later in the morning it's feeling better but it certainly puts a damper on intimacy. My hubby never suggests it unless I do, he's worried about hurting me. I'm going to see my family dr on Thursday but I don't think he's going to know what to do with me since I am on Arimidex, etc.

Frustrated,

Brenda

Dx 8/6/2006, Stage II, Grade 2, 1/6 nodes, ER+/PR+, HER2+
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Jul 24, 2007 03:46PM esserbre wrote:

Dear Peachy
I'm sorry to hear that you and your hubby are going through such a tough time. I love your flowers, just shows what a great attitude you have, it's certainly inspiring to others. Sorry I didn't mention that before, I just was anxious to let you know the Replens wasn't my favourite, too much discomfort. Might be worth a try for you though, some think it's wonderful.

Brenda

Dx 8/6/2006, Stage II, Grade 2, 1/6 nodes, ER+/PR+, HER2+
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Jul 30, 2007 03:11AM deboodle wrote:

Hi Ladies...

This is my first post here, and what a lifesaver to see that so many people have this problem. I searched the internet over to find an answer...and of course, there is none. My big question to you ladies is....how do you go about having a papsmear? I am overdue and very nervous about going through the awkwardness and pain. I swear he will not be able to get that duckbill in there. I too have been told my insides look like a 70 yr old (and I'm 46). I haven't had sex for 18months, as it is near on IMPOSSIBLE....I'm feeling like a freak these days, one breast and NO sex please....

Deb
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Jul 30, 2007 04:37AM NativeMainer wrote:

Be sure you talk to your dr before the Pap--explain your situation and concerns. The duckbill comes in difference sizes, the dr can use a smaller one if need be.

dx 3/07, Stage 2, Grade 2 IDC, 2.8cm, ER+PR+, Her2(-), SN-, lumpectomy & rads, mastectomy 8/15/08, right prophy mast and bilateral DIEP recon 6/21/10

Dx 3/9/2007, IDC, 2cm, Stage II, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Jul 30, 2007 06:54PM Naniam wrote:

Ladies, I am 62 and I have had a horrible time. My GYN doc is the one that ordered my mammo when we discovered my breast cancer but gaveme Estrace/estradiol cream when I got really bad vaginal atrophy. (Replends burned when I tried using it.)Estrace is absorbed into the bloodstream- I think this is the same type estrogen that was in my Climara estrogen patches.

I am thinking that ESTRIOL is the estrogen that is produced naturally by our bodies and IF some of us have to use an estrogen product - make sure you get ESTRIOL and not Estradiol/Estrace. It is available to us and my oncologist wrote the prescription.

Hope this helps.
Dx 8/18/2005, IDC, 3cm, Stage IV, Grade 2, 0/7 nodes, mets, ER+/PR+, HER2-
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Jul 30, 2007 08:49PM BlindedByScience wrote:

There are three types of estrogen we usually talk about: estradiol, estriol and estrone. From what I've read, there is not a lot of evidence that estriol is better than estradiol although it has been said that estriol is a less potent estrogen. It has also been said that estriol may have less of tendency to enter the bloodstream than estradiol but the evidence I've seen for this is weak. Both seem to have some risks and some benefits.

There are some doctors who maintain that estriol is the 'protective' estrogen and, in high dose, may inhibit bc. However, estriol can stimulate bc cells to grow, as does estradiol, in low doses.

Both estradiol and estriol can be obtained as 'natural' hormones as both are produced by our bodies. Natural hormones are usually prescribed as a cream, though, and this can complicate the dose-per-application. One oncologist I've talked to refused to prescribe estriol cream because she wanted to avoid having her patients use too much at any one time.

Using supplemental hormones is a risk that isn't well-qualified, but some women chose to use them as a quality of life issue. I'm one of them. I use an estring right now, but have considered the estriol cream.

The site below goes even further in making hormone recommendations (ones I can't support), but may be of interest to others:

http://www.project-aware.org/Resource/articlearchives/hrt-breastcancer.shtml

here's one of their recommendations:

Patients are also likely to benefit from estriol with its potential for protection against breast cancer recurrence due to its low estrogenic activity, which possibly results in binding to estrogen receptors without stimulation of receptor. This is recommended in a higher ratio of estriol to estradiol than the typical ratio seen in Biest (80%/20%). For patients with a higher risk for breast cancer, we recommend 90%/10% estriol/estradiol.
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Jul 31, 2007 05:19AM Naniam wrote:

BBS, you know far more on this and other supplements than I ever will. I know that when my GYN gave me the Estrace/estradiol it was 1 gm 2-3 times a week. When oncologist didn't like that - they gave me the Estriol, 1 gm. 2-3 times a week. He liked it better; felt it was safer for me. That's as far as my knowledge goes - based on my experience and the explanation I got.

I just got so bad I had to do something - intimacy aside; I was miserable, the dryness was to the extreme and I was so uncomfortable that for several days my underware had to disappear.

You are 100% correct in that any hormone given, which ever form, should be used "only" if we are informed and "only" if there isn't anyother way.

As always, thanks for your great information.

Brenda
Dx 8/18/2005, IDC, 3cm, Stage IV, Grade 2, 0/7 nodes, mets, ER+/PR+, HER2-
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Jul 31, 2007 12:28PM 2angels wrote:

Deb,
I too was worried when I went to see the gyn. about my atrophy, intimacy issues... and she said even though my cervix was removed with everything else, I needed to have my vagina smeared yearly. She did use a very small duckbill. It was a little bit uncomfortable but I think it would have been worse if she did not know my issues and went with the normal. Let your doctor know ahead of time and I am sure they will take extra care not to hurt you. I will be 44 in a couple of weeks and have been dealing with these side effects for 3 1/2 years now. I am wondering how long it will take for the estrace work so that my husband and I can try to resume the intimacy we once shared. I feel so bad for him. He does not want to hurt me and so far it just plain does. That is why quality of life won out for.

Is there anyone who is doing the estrogen cream that ishaving the side effect of pretty bad nauseau? I hate the way I feel the next day after I use it. I almost feel like I am going to vomit while trying to get ready in the morning. Once again a lovely side effect to deal with.
Ann
Dx 10/1/2003, IDC, 5cm, Stage IIIb, Grade 2, 12/14 nodes, ER+/PR-, HER2-
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Jul 31, 2007 12:46PM Naniam wrote:

Ann, use the vaginal estriol vaginal cream 2-3 times a week and am doing so much better. Intimacy for my husband and I is OK now. I make sure I use it at least twice a week and have been for 2 months. I wasn't very good at using the estrogen cream prior to that but it has made a difference and replends and other stuff only irritated me. I'm 62 now. Never had the side effects you are talking about - certainly not with the vaginal estrogen cream.

Brenda
Dx 8/18/2005, IDC, 3cm, Stage IV, Grade 2, 0/7 nodes, mets, ER+/PR+, HER2-
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Aug 1, 2007 03:01AM deboodle wrote:

Do you need a script for Estriol?

Deb
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Aug 1, 2007 03:13AM Naniam wrote:

Yes, Estriol is prescription only. Oncologist wrote the script for me.

Dx 8/18/2005, IDC, 3cm, Stage IV, Grade 2, 0/7 nodes, mets, ER+/PR+, HER2-

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