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Is it safe to use Premarin cream if ER-/PR-

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I did not know where to post this question so I will do so here. I want to know if it is safe to use Premarin vaginal cream a couple of times per week if I am estrogen and progesterone negative. I saw my gynecologist Tuesday for a routine pap (had hysterectomy but left cervix) and he said he "thought" it would be okay to use the cream. I called the BS office but they did not call back yet. Not sure what to do. Thoughts?

Comments

  • peggy_j
    peggy_j Member Posts: 89
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    I agree--this is a good question for your doctors. If it was me, I'd ask my medical oncologist.

  • coffeelatte
    coffeelatte Member Posts: 109
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    Peggy, that is a good idea. I just went into my settings to figure out why my diagnosis and stuff does not show at the bottom like others; I hope I fixed it. But anyway, because my diagnosis is DCIS, I don't actually see a MO. I was referred to one at my insistence but he only talked with me for a few minutes just enough to say I don't require chemo at this time. But it would not hurt to call his office and ask that question.

  • wenweb
    wenweb Member Posts: 471
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    I'm estrogen positive and I use vaginal estrogen.  It's one of those touchy subjects, but boils down to quality of life issues for some of us.  What I use is Vagifem, which is a little tablet, so it's not messy like the Premarin.  I also only use it once per week which (I feel) is how I'm OK using it, even though I have had the blessings from all of my docs.

  • corky60
    corky60 Member Posts: 453
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    Ask your MO this question for the best answer.


    I am highly, highly ER+ and was told not to use any estrogens, cream, tablets, capsules, you name it. I had been using the cream twice per week to prevent UTIs and know the estrogen was absorbed systemically because when I stopped using it I experienced hot flashes as well as localized dryness. Using a half or full applicator coconut oil for dryness helps immensely and taking cranberry capsules three times per day has so far prevented UTIs.

  • BikerLee
    BikerLee Member Posts: 78
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    i was really suffering with the premature ovarian failure induced by chemo... and i am actually on hormone replacement therapy.  my medical oncologist and surgeon and ob gyn all thought this to be a reasonable approach. my quality of life has really rebounded.....  i'm using an estrogen patch and am steadily working my way towards the smallest size patch (i'm using the middle-size right now).

    the research surrounding hormone replacement is really interesting, and the knee-jerk response of never using hrt has been called into question.  i did a ton of reading and so on before making my decision to use hrt.  at the end of the day, everything is better... i feel better, i sleep better... and so on.  

    everything i've read suggests that the vaginal creams deliver little systemically... but provide much benefit "down there"....  

    i don't know if that helps, but that's my experience.

    i have had a variety of responses to my hrt ... some extremely negative and some very positive... and everything in between.  at the end of the day, having a clear discussion with your health care providers and some solid research should lead you to a decision...  

    with kind regards,

    lee

  • cp418
    cp418 Member Posts: 359
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    Avoidance of estrogen replacement by hysterectomized women estimated to result in lost lives
    July 24, 2013. In an article published on July 18, 2013 in the American Journal of Public Health Yale researchers calculate that nearly 50,000 unnecessary deaths have occurred among women between the ages of 50 and 69 years who had a hysterectomy yet had not availed themselves of estrogen replacement therapy due to fear of its adverse risks.

    Findings from the Women’s Health Initiative (WHI) study published in 2002 indicated a greater risk of breast cancer and coronary heart disease among women who used a combination of estrogen and progestin as menopausal hormone replacement therapy. Progestin is routinely combined with estrogen to protect against increased proliferation of the uterine lining that can result from the administration of unopposed estrogen. However, in the WHI study arm that investigated the use of estrogen alone (which is prescribed without progestin to women who have had hysterectomies) there was a decrease in the risk of breast cancer and heart disease, and a lower rate of mortality in comparison with women who received a placebo. Nevertheless, the backlash from the widely publicized findings of the first arm of the study frightened many women away from any kind of hormone replacement therapy, including estrogen alone or bioidentical hormones that have been associated with fewer risks. "Sadly, the media, women, and health care providers did not appreciate the difference between the two kinds of hormone therapy," commented lead researcher Philip Sarrel, MD. "As a result, the use of all forms of FDA-approved menopausal hormone therapy declined precipitously."

    "Estrogen avoidance has resulted in a real cost in women's lives every year for the last 10 years—and the deaths continue," he added. "We hope this article will stir an overdue debate and raise consciousness about the health benefits of estrogen-only therapy for women in their 50s with no uterus."

  • corky60
    corky60 Member Posts: 453
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    I used bioidentical estrogen only and maybe it helped me avoid other problems but here I am with BC. I guess I am one of the "outliers". Each woman is different and this topic should be discussed with her dr. My primary care dr. told me to stop the oral ERT and just use the cream. This was a year and a half prior to the BC diagnosis. We are each different.

  • wenweb
    wenweb Member Posts: 471
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    corky60, I agree with you wholeheartedly. We are each different and there is no way to ever tell if what we did or didn't do caused our BC or a recurrence of.

  • Blessings2011
    Blessings2011 Member Posts: 1,801
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    I am 100% ER+ and my MO wholeheartedly approves the use of Premarin cream... in small amounts, applied locally, twice a week.


    Without this, I have burning, pain, itching, and bleeding from fragile atrophied vaginal tissues. I also have extensive bladder issues from the same fragile, atrophied tissues.


    Premarin cream, while containing estrogen, does not enter the bloodstream as do the pills given in HRT. This is a crucial difference in the studies cited. What estrogen may enter the bloodstream is only detected in extremely minute amounts.


    In between the use of Premarin cream, she recommends a product called "V-Magic" made by Medicine Mama's Apothecary. It is billed as an "Intimate Wellness Cream" and contains only pure organic ingredients. This keeps the tissues moist, but only estrogen cream can restore fragile atrophying tissues.

  • coffeelatte
    coffeelatte Member Posts: 109
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    I am really unsure what to do. The breast surgeon's office called me back and basically said they don't know in my case because of the ER- status. The nurse on the telephone said they always go with the "no estrogen ever if you have had breast cancer," but she said the doctor was not in and the nurses in the office were divided on using it or not. I used it before my BC diagnosis and for me I know I get some systemic because I use ony 1/4 of a dose or I get a bad migraine with visual aura. It sure does help with the quality of life issues and my husband is REALLY hoping I can use it. I am scared, though, but I know the WHI study actually showed a reduction in BC cases with estrogen alone. Geez, I can give myself a headache just fretting over it.

  • corky60
    corky60 Member Posts: 453
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    That's interesting, Blessings2011, that we have nearly the same diagnosis but our MOs have given us different instructions. I didn't have MX so maybe that is the difference. Quality of life matters and I'm glad your treatment is working for you. I was using a tiny amount of the bioidentical cream twice weekly and when I stopped I had hot flashes so I know it was being absorbed systemically. I will look up the other cream that your MO recommended. Coconut oil seems to work too so far. Thanks for the info.

  • coffeelatte
    coffeelatte Member Posts: 109
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    I may try the coconut oil. A few years ago I used Replens, but I don't think I stuck with it long enough. I may try that too before going to the Premarin cream. If I did not get such nasty headaches on the vaginal estrogen (all types) I would just do the Premarin now, but the headaches can get pretty scary. One landed me in the ER because the vision loss scared me so much the first time.

  • Blessings2011
    Blessings2011 Member Posts: 1,801
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    corky60 - I'm not surprised we got differing opinions from our MOs. That seems to be the norm everywhere.... the rules change according to each doc's personal and professional experience with...whatever. Sure makes it confusing for all of us, though... Regarding the "V-Magic" - remember, it's just for lubrication. It won't restore the atrophying tissues. It does feel VERY soothing, though...


    I just remembered the other thing the MO told me: "Use it or lose it" when it comes to intimate activities. Even though sex may be painful at first, she said that it was actually helpful to the tissues, once the severe inflammation and pain was under control.


    Oh, coffeelatte - I had no idea you got such awful headaches from the Premarin! That in itself would probably keep me from using it!!! Hope you can find an alternative....

  • wenweb
    wenweb Member Posts: 471
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    For a very long time, I thought my headaches were associated with the use of vaginal estrogen. This because I would (more likely than not) have a headache the day after I used the estrogen. Now, the pattern of my headaches has changed, and there is not a direct association. It's very easy for me to assign what I think is the cause of frequent headaches from either a medication or lifestyle choice. Do I think that vaginal estrogen is not systemically absorbed? I absolutely think it is, albeit minutely (I hope!!) I was plagued with recurrent bladder infections after menopause and don't think that any amount of moisturizer would deal with a problem that is directly due to lack of estrogen.

  • corky60
    corky60 Member Posts: 453
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    I started ERT years ago as a treatment for migraines. The sudden loss of ER after oophorectomy brought on migraines! Now it's poor sleep or even a drop in the barometric pressure. They can come on during a storm. Edited to say: I also had recurrent cystitis and found that taking cranberry capsules three times per day has helped. So far so good, seven months without one. The brand is CranRich Super Strength Cranberry Concentrate.

  • annabelle29279
    annabelle29279 Member Posts: 1
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    Hi! What brand of cranberry capsules are you using?