Topical oestrogen cream after bc: is it safe?

Hi ladies

Not been on here for a while but as life goes on after bc, other questions arise.

Following bc dx in 2008 (10mm, grade 2, no nodes, ER/PR+) with 2 years of Zolodex, I had hyster (unknowingly had endometrial hyperplasia), including removal of ovaries, last year. I’ve still got 2 years of Tam left.

I’d prepared myself for associated risks of no oestrogen for heart disease, osteoporosis, mood swings, vaginal dryness, flushes etc and thought I’d got all bases covered with medication, supplements and creams. What I hadn’t anticipated or read about was the effect of no oestrogen on the uriniary tract.

I’ve had 5 UTI’s in 7 months - each one leaving me low and needing antibiotics. I’ve had a renal scan (all clear) so now I’m on a prophylactic antibiotic.

My question is: As I’m taking Tam and my only source of oestrogen is that produced from body fat (of which there is quite a bit nowadays), how safe would a low dose topical vaginal oestrogen cream be?

The UTI prob is causing me untold anguish and is affecting my relationship with my husband; given this quality of life issue, should I pursue using the cream when balanced against a bc recurrence, particularly as my bc was small and caught early?

I’ve just had my third mammo since dx - all clear, so I’m now thinking the risks of recurrence are being outweighed by quality of life issues.

Does anyone have any experience or thoughts on this one? I’d appreciate any comments.

Best wishes

Claire

well its odd that this question came up today. I am sure that i am not the only one that wonders why, apart from bad luck I got this cancer. Was I on the pill too long, had my children too late etc, but that was years ago.

Last night I was thinking about the fact that when i was first diagnosed with osteoporosis i was prescribed an oestrogen gel that the label said apply to arms and legs, doctor said dont put it on your arms we are starting to wonder about the link with BC. After I cannot remember how long,probably a year, I started to feel unhappy about using it, no logical reason at all, just wanted to stop. So I did.

I dont know if that was the cause, who does, I do own a pair of yellow wellies after all (only regulars on this site will get that one). And even if it was, I am not going to beat myself up about it, it was not my decision to use it.

anyway back to your question, I am sure there will be people on here with more knowledge than me, its just odd that last night was the first time i had remember using the gel and when i woke up there was your thread.

I was recently at a study day called menopause after cancer and we had an excellent speaker who is an expert in this field. She said some oestrogens are contraindicated. Eg premarin and earring however there are some low dose topical treaments with very good responses. Ovestin has a dose 0.1% but currently has sourcing issues however orthogynest has even lower estriol of 0.01%.

The lowest dose oestrogens are in vagifem which come in 25 or 10 microgram doses which as the prof said is ‘less than the circulating oestrogen from the adrenal glands but we wouldn’t get the adrenal glands remived’ to lower your risk of BC.

However before you go down the route of hormonal therapies it may be wise to try non hormonal ones first. Things like replense, glide, yes, sylk which are lubricants and would be used 2-3 times a week. The effects can take few week or months to become apparent. Also vagi-soy, wild yam cream, phytoestrohgen cream, are thought to help with soreness and also can help with symptoms longer term and not just when you are using them. Oxyprep cream is on trial just now so awaiting results from this study.

For good vaginal/ urogenital health avoid over washing, dont use perfumes or deodorants, loose cotton knicks are best. Drink plenty of fluids.

Lulu xxx

Thank you both for your replies - it does seem there’s a cause for concern where there’s a history of bc/cause bc but I’m wondering whether the benefits would outweigh the risks - isn’t this what we’re told when taking our bc meds ie Tamoxifen?

I’m using Replens and trying to keep my fluid levels up - sometimes fighting a losing battle with the hot sweats and can feel myself becoming dehydrated which I know will add to the probs I’m having.

Will keep on using the non-hormonal approach for now I think but will talk to the medics at my next review - and just keep on swigging the water and sloshing around in the meantime!

Take care, ladies

Claire

hi claire

i was at another menopause study day this evening… the professionals there were very pro oestrogen creams and topical treatments and dont classify it as HRT as it doesnt require the progestin treatment which women with a uterus still require when taking systemic HRT.

the risk of taking HRT for 5 years is less than drinking 1 large glass of wine a day or having a bmi over 35.

and the risk to bone, brain and cardiac health is much improved.

im going to see my gp tomorrow as think with my family history of heart disease, diabetes, stroke and dementia the HRTs reduction in these diseases is more beneficial than the smaller risk of developing a recurrence of BC (even with a gene mutation).

Lulu xxx