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Oct 5, 2017 09:45PM
There are 2 forms of Estogen women use, Estradiol and Estriol. Estradiol is the stronger Estrogen, and the form that ebs and increases intermittently during a normal menstrual cycle. Estriol is the form of Estrogen that predominates during pregnancy, and is a less potent Estrogen, and has much decreased risks of increasing the thickness of the uterine lining (uterine dysplasia) Women can use either of these Vaginal Estrogen forms, even women who had ER/PR positive bc are still able to safely use them because it doesn't have a systemic effect. Rather the Vaginal Estrogens stay localized in the vaginal/uterine area. They help to reverse thinning of the vaginal lining, decreasing pain, irritation and possible tears with sex.
Estradiol comes in the form of a prescription Vaginal Ring Insert called an Estring (that is left in the Vagina for 90days), Estrace, vaginal cream, ( same usage as the Vagifem and Vagifem, a Estradiol Vaginal Suppository., (used 1 daily for 2 weeks, then twice per week going forward)
Estriol is also by prescription, but is usually a specially Compounded Prescription Vaginal Suppository, that is more often prescribed by a Naturopath or a MD interested in Natural Medicine.
Whether to use Estradiol vs Estriol depends on several factors. Estradiol is the stronger Estrogen, and will more rapidly improve the health of your vagina. However, it is also known to increase the thickness of the Uterine lining, without Progesterone to counterbalance Estrogens effects, thus possibly increasing the risks of Uterine cancer.. Artificial Progestins are known, in and of themselves to increase the risk of breast cancer, which is why they finally stopped HRT. Natural Progesterone does not have a harmful proliferative effect on breast tissue, as has been shown through some well designed French Studies. Natural Progesterone has been safely shown to counterbalance the Vaginal Estrogens without increasing breast OR Uterine cancer. ( see the French Studies)
That seems like a no brainer, why Would you use an Artificial Progestin ( like Medroxyprogesteron) as a substandard, and dangerous substitute for Bioidentical Progesterone??? Here is a quote that explains it all
Synthetic progestins were originally developed to overcome the short half-life of progesterone and its high production cost.
Basically FOLLOW THE MONEY.
SO I plan to use Vaginal Estrogens only with concurrent cycling of Bioidentical Progesterone, off for the first 5 days of the month, and on for the remaining 25 days of the month (to mimic the cycling that would naturally occur during menstruation)
Progestins and progesterone in hormone replacement therapy and the risk of breast cancer
Carlo Campagnoli, Françoise Clavel-Chapelon, [...], and Franco Berrino
Additional article information
Controlled studies and most observational studies published over the last 5 years suggest that the addition of synthetic progestins to estrogen in hormone replacement therapy (HRT), particularly in continuous-combined regimen, increases the breast cancer (BC) risk compared to estrogen alone. By contrast, a recent study suggests that the addition of natural progesterone in cyclic regimens does not affect BC risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. The increased BC risk found with the addition of synthetic progestins to estrogen could be due to the regimen and/or the kind of progestin used. Continuous-combined regimen inhibits the sloughing of mammary epithelium that occurs after progesterone withdrawal in a cyclic regimen. More importantly, the progestins used (medroxyprogesterone acetate and 19-Nortestosterone-derivatives) are endowed with some non-progesterone-like effects, which can potentiate the proliferative action of estrogens. Particularly relevant seem to be the metabolic and hepatocellular effects (decreased insulin sensitivity, increased levels and activity of insulin-like growth factor-I, and decreased levels of SHBG), which contrast the opposite effects induced by oral estrogen.