Letrazole and vaginal oestrogen

Has anyone been allowed to use Vagifem whilst on Letrazole?
I keep reading different opinions on this. Thanks

I had vaginal atrophy when I first started Letrozole. My oncologist insisted that I move on to Tamoxifen in order to use Vagifem/Vagirrux. In the end I did not want to change to Tamoxifen and actually it was more vaginal dryness than atrophy so I now use Hyalofemme which is brilliant. I understand you can get it on prescription but I just get it from Amazon when I need it. There are threads on this if you wanted to search and I do not believe anyone has been allowed to have topical oestrogen on aromatase inhibitors.

I was prescribed a vaginal moisturiser and also vaginal oestrogen due to dryness discomfort while on Letrozole. My oncologist is the one who advised this and explained that the level of oestrogen absorbed here would be minuscule & effectively not reach the blood stream. But I understand what you mean that there are differing opinions on this topic.
Just want to note, I haven’t used either product yet though as my symptoms appear to have eased after starting a medication break which I’m on at the moment.

Thanks both
I am seeing my oncologist in a few weeks so will discuss it with her. Its the atrophy that I cant cope with.
Ive been on the Letrazole about 7 weeks and have started having leg and lower back aches. Plenty to discuss!
Feeling old!


Hello fellow sufferers of vaginal atrophy on those wretched tablets ( in my case Letrozole). I’ve spent the last couple of weeks researching every vaginal moisturiser available over the counter or online in the uk. Today had phone appt with GP. She said that a hormone product was by far the best solution but felt she couldn’t prescribe it because oncologist unlikely to approve. I have now been prescribed two boxes of YES Vm applicators per month on repeat. GP also invited me to review if want to change to another product. Sadly the range of products on prescription is limited compared to the number of products on the market. Think I will discuss with oncologist at next appointment though as would be interesting to get her opinion. Love to all from Tulip x

I was prescribed VAGIRUX which is topical low dose estrogen by my GP for VA on Letrozole. I was having a spate of constant UTIs

I checked with her that it would be OK, and with the BCN and with my oncologist as I read the leaflet and it said it was not for anyone who has/had breast cancer

My oncologist was Ok with it (basically said the jury is still out on it ) but hoped I would try Replens or Hylafemme instead. The BCN was happy with it.

I did use the first packet but have now moved to Hylafemme and the situation seems to have improved as I am no longer taking the AIs

Happy to report weird sensations gone in the ‘undercarriage’ and no UTIs


I wasn’t allowed to use a hormone moisturiser.

I’ve tried Hyalofemme as recommended on here but that made me itch like mad

I’ve tried YES but that didn’t help so I’ve just bought replens from Sainsbury’s. Don’t know if this is a different strength to what would be prescribed but I’ll give it a go. It’s an absolute nightmare

Good luck xx


I stayed on Letrozole for a year and the leg pain became debilitating as I could barely sleep too.
I spoke to my oncologist and had a 6 week break before starting Anastrozole and so far so good. There are other options so please don’t suffer needlessly, 5yrs is a long time to put up with awful side effects.

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Dr Liz O’Riordan posted this a while ago.

Published in Nov 2023 now also on Pub Med which is government website in USA.

Conclusions and Relevance Results of this study showed no evidence of increased early breast cancer–specific mortality in patients who used vaginal estrogen therapy compared with patients who did not use HRT. This finding may provide some reassurance to prescribing clinicians and support the guidelines suggesting that vaginal estrogen therapy can be considered in patients with breast cancer and genitourinary symptoms.

Worth a chat with oncologist or GP. :smiling_face_with_three_hearts:


Thanks! That is really interesting x

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Could you use Premeno Duo vaginal capsules? Ask your oncologist/gynaecologist first. I take Letrozole and this has helped a lot!

Best wishes!

Im using Replens until I speak to her but I’m not confident it will help my atrophy.
Happy days!!

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Before breast cancer I used Replens and Vagifem with Oestrogel and mirena coil. I had repeated infections with Replens and found out some of its ingredients can be irritating so swapped to Yes Moisturiser also on prescription. I think it was the glycerin that caused the problem.

Breast care nurse referred me to menopause clinic to discuss Vagifem or Intrarosa (DHEA), I showed them the studies and a letter from oncology nurse with vaginal atrophy information on moisturisers and vaginal oestrogen treatment but wouldn’t commit to a prescription. GP told me to talk to my oncologist even though I had the letter!

Bangs head against the wall! Hoping the wait isn’t too long. I don’t want to go back to not being able to wear underwear (except when I went out) and walking around in skirts unable to even consider trousers! Not to forget the pain going to the toilet :sleepy: This was during 2020 so lockdowns meant not in work and managed to redeploy as WFH. It was horrendous and don’t ever want to go there again.

In case needed I have edited my reply with the PreMeno Duo weblink in the UK. Best wishes with whatever you see best for you to use! :crossed_fingers:t3:

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Well, saw my oncologist yesterday.
Told her my concerns re vaginal atrophy. She said that as Replens wasn’t helping I could use vaginal oestrogen. She said that because my cancer was tiny and found early there was no problem with it. I could have kissed her!!!