Estradiol for vaginal atrophy after breast cancer. Is it safe?

Kensiejames: 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.

Hey there! I am just now seeing your post to me. I have to get better at checking in with this site. My humble opinion, the blood test to check your estrogen levels is very telling. My number is well below my oncologist expectations.
Recently, my PCP spoke out against my using estrogen creams. I understand his concern. Estrogen cream does get absorbed into your body. When I first started using, GYN had me at 1 gram a week, and my blood work showed estrogen level was above the norm for my age group . Scary for a breast cancer survivor.
So it does get absorbed into the bloodstream . For me, 1/2 gram every two weeks was just enough to solve my problem and keep estrogen levels in the negative numbers.
I am 20 years out now, and God willing I will remain in remission. 🙏🏻

Kensiejames: 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.

Eleanorrigby:
OK, thank you. I tried Replens a while after the chemo, and I was so dry that getting the applicator in was painful. It has been a couple of years since then, but maybe I should work a little harder at it. Again, thanks for your perspective.

I get the one where there are individual applicators for each use. So 6 in a box. You could actually squeeze just a little bit out of the applicator and spread it around the thip and further to make it slide right in. I tell the oncologist that the worst of anastrazole is the vajayjay - swollen, inflamed, sore, painful. But this Replens has worked great for me over the last two years! Hope you can make it work for you.

I 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.

My breast surgeon said the vaginal estrogen is safe because it's method of estrogen delivery is different than HRT. I have read several articles stating the same. Supposedly, the "black box" warning is over 20 years old and the study back then was very small, and now they are saying the study is outdated, inaccurate, and are trying to have it removed. My oncologist and radiologist both say no. Geez!