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Estradiol for vaginal atrophy after breast cancer. Is it safe?
I have developed severe atrophy 25 years after estrogen receptive breast cancer. Did chemo, radiation and 5 years of Tamoxifen. I was always told NO estrogen. I am experiencing extreme pain and bleeding so sexual intimacy is impossible. I also have been diagnosed with Lichen sclerosus. I am 65 years old. My gyno has prescribed Estradiol vaginal cream 0.01%. I am told the new view and trials say is it is safe for breast cancer survivors. Anyone been down this route or had their gynecologist say this? I really want to try this for quality of life with my husband but I am also very scared.
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Both my gyn and my oncologist have said it is safe for me to use Estradiol Vaginal Cream because it is not systemic (like an estrogen patch).
I use .01% 1/2 gram just two or a week. I’ve been using it for about a year and a half. It has dramatically improved dryness and pain.
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2 ReactionsI've been told the same: were your receptors positive & HER negative? OR?
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1 ReactionFrom my research, I believe there are three naturally-occuring types of estrogen that circulate in your body: estradiol, estriol, and estrone. Estradiol has been used for years for vaginal dryness (e-string, Estrace, Vagifem, etc.) and can be either pharmacy-ordered or compounded (bio-identical). About 10 years ago I used a compounded vaginal cream of estriol, as it's the weakest estrogen but my oncologist disapproved of it so I stopped but it's back in favor again now. Ugh, sometimes I think it's just a CYA situation for doctors to advise against it, which is why the new study is so important because they can show some research that shows no ill effects. I put the link in a different response, but here it is again (just the abstract as the full article is behind a paywall) taken from the American Journal of Obstetrics and Gynecology:
https://www.ajog.org/article/S0002-9378(24)01126-8/abstract
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4 ReactionsKensiejames: I am just looking at your March 2024 comment in July 2025. Your specifics are SO HELPFUL. And relieving. I am 3 years after estrogen receptor+ breast cancer/chemo/radiation and am on Letrozole. (And I'm in my late '70's.) I read about estrogen cream for the vaginal dryness that keeps me from intercourse with my husband, and queried my oncologist via my electronic chart. She didn't reply personally, her RN did. She said they thought it was safe and offered to phone in a prescription for me. That's it. There are some women's doctors who are good at their specialty but really don't know how it feels to have cancer, and don't appreciate how much we REALLY DON'T WANT TO HAVE IT AGAIN. So anything that has "estrogen" in the name that we're thinking of trying feels scary unless we have reassurance from a professional that it really is safe. So--thank goodness for this site, and a breast cancer site on Reddit for helping us all have more peace of mind. Thank you, Kensiejames.
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4 ReactionsI have had conflicting medical advice regarding estradiol vaginal inserts for dryness. I have ILC and I am wondering if anyone was told to stop using this medication or if it is ok to continue using the inserts. I have had a lumpectomy, 19 sessions of radiation and started taking Letrozole this week.
Thank you!
My pharmacist said not to do estradiol while on Anastrozole. My Oncologist said it was fine as it is not systematic. I am choosing to continue due to the benefits.
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1 Reaction@mariam58, I moved your question about estradiol vaginal inserts while on an aromatase inhibitor (Letrozole) to this active discussion so you can connect with others.
- Estradiol for vaginal atrophy after breast cancer. Is it safe? https://connect.mayoclinic.org/discussion/estradiol-for-vaginal-atrophy-after-breast-cancer-is-it-safe/
Weighing the pros and cons, understanding risk vs quality of life make decisions hard. Reading how other women have informed themselves, the criteria they used to decide can be helpful. I hope that this discussion will give you more information to have a well-informed discussion with your oncologist.
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2 ReactionsI am on letrozole and noticed vaginal dryness as well. My wonderful gynecologist recommended Bonifide reveree. She gave me a code to use to reduce cost. Every three days it is used internally and has no estrogen so my oncologist approved. It has worked wonders. I highly recommend it. A friend who is a gynocologist said she recommends any women over 50 use it. Hope this helps. My gynecologist and survivorship nurse practitioner also said using estrogen cream internally will not impact cancer issues and is another option if I want to use it.
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1 ReactionI’ve used estradial in the past, cream and oral. And then I got cancer. Yes, i’ve read the new thought on it but for me. I’m not going back to it. And my medical oncologist agrees . I’m still looking for a substitute. It’s a very personal decision. I figure i want to avoid anything might trigger a recurrence.
This product has no estrogen in it. It uses a natural hydration and therefore is recommended for we women who can’t use estrogen based products. Disciss it with hour physicians. I have had all of mine agree it works wonders. P