As estrogen levels decline during menopause, it’s common to experience vaginal dryness. This uncomfortable menopausal side effect can cause the vaginal area to feel itchy or sore, and can lead to additional side effects like painful sex and pelvic pain. A commonly prescribed remedy for these irritations is estrogen cream. But is estrogen cream safe for women with breast cancer?
Though many women with breast cancer experience vaginal dryness as a result of estrogen-draining cancer treatments, the messaging around the efficacy and safety of estrogen creams for this group is mixed, with some suggesting it’s linked to cancer recurrence. A First for Women reader who just completed breast cancer treatments asked our medical expert, a gynecologist and director of Women’s Midlife Services at Michigan’s Holland Hospital, for advice on the issue. Here’s what Dr. Barbara DePree had to say.
Using Estrogen Cream for Vaginal Dryness
Q: I recently completed treatment for estrogen-positive breast cancer, including removal of my ovaries, and am battling vaginal dryness and joint pain as a result. My doctor prescribed estrogen cream, but the package has a warning that women who have had breast cancer shouldn’t use it. What can I do?
A: Please don’t be alarmed. Those package inserts haven’t been updated to reflect the latest research, and we don’t know when they will be. Growing evidence suggests that, unlike oral estrogen, topical estrogen, which is placed in the vagina via a cream, ring, or tablet, isn’t absorbed into the bloodstream. So, it doesn’t put you at risk for cancer recurrence. And topical estrogen is widely reported to revitalize vaginal tissue and ease dryness, itching, and burning.
That said, when I see a patient with a history of breast cancer experiencing vaginal dryness, I always suggest nonhormonal options first, like taking 3,000 milligrams of sea buckthorn oil capsules twice daily. A small 2014 study found that compounds in the oil help vaginal tissue and lining retain moisture, and many postmenopausal women in the study reported beneficial effects. There are also non-estrogen prescription options, like Intrarosa and Osphena, that you can talk to your doctor about.
As for your joint pain, joints need estrogen, so when levels of the hormone wane, pain and inflammation are common. To ease the pain, I suggest walking regularly and doing light stretches for 10 minutes afterward to improve circulation and lubricate your joints. Also helpful? Loading up on anti-infammatory foods like whole grains, vegetables, nuts, fruits, and fatty fish such as tuna and salmon.
Meet Our Expert
Barbara DePree, MD, is a gynecologist in private practice and the director of Women’s Midlife Services at Michigan’s Holland Hospital. She’s also a Certified Menopause Practitioner and the founder of MiddlesexMD.com, an educational resource for women’s sexual health in perimenopause and beyond.
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
A version of this article originally appeared in our print magazine, First For Women.
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