Latest on using topical oestrogen creams like Ovestin while on Letrozole or similar

Russian_Blue23

I've nearly done 4y on letrozole. My breast cancer was 6mm ER/PR positive. I had local wide incision followed by radiotherapy, no chemo. I was told to stop using Ovestin Cream and Vagifem. I get UTIs and vaginal dryness and soreness. I'd dearly like to recommence Ovestin. My GP said the medical thinking was changing a little toward allowing use of topical oestrogen creams while still on Letrozole etc. Has anyone else investigated this with their GP/oncologist? Since I was ER and PR positive I have held off but I'd like to know what other people's experience with this has been. 

Afraser

I’ve been using Ovestin for about three years. I finished ten years of Letrozole a year ago. One of the factors my surgeon raised was that at my age (about 75 when I started Ovestin), the level of oestrogen I was producing was already low. I use far less than the normal recommended dose but it helps a lot. Best wishes. 

Russian_Blue23

Thank you Afraser. I think I will have to do 7y of letrozole and I have done 4y so far, but I am wanting to know if I could recommence Ovestin before the 7y is up. 

Afraser

I did start using it while still on Letrozole but my age was a significant factor. 

PrisMay1

I started using Vagifem after a course of AIs (Tamoxifen and Arimidex) when I was in my mid 50s. When I was diagnosed with BC again last year I was told that it’s quite safe to use Vagifem whilst taking AIs. Both my cancers were hormone positive. I also use a personal lubricant which I find also helps. 

Russian_Blue23

Thank you PrisMay1. Was it your GP on oncologist or surgeon who told you it was safe? I am waiting on an appointment with my oncologist to discuss this. 

J-Nold

I’m a gynaecologist as well as a having a newly diagnosed breast cancer. I have looked this up for patients and there is extremely low systemic absorption of estrogen from the vaginal preparations. You could ask if a short course of Ovestin/ vagifem for 6 w at a time is ok, if your Oncologist is on board, as the benefit will outweigh risks in some cases. Just my opinion-disclosure-  gynaecologists are very pro- hormones for symptom relief of urogenital atrophy. 

Russian_Blue23

Thank you Joanna. That is very interesting and encouraging. I am hoping to discuss this with my oncologist soon. It would make a big difference to my comfort. May I ask you something else? I seem to get UTIs a lot. Even after taking 10 day courses of Cephalexin, in a few weeks it comes back. Is Hiprex useful and does it work? Do you recommend any vaginal moisturisers to help with vaginal atrophy and dryness/soreness? I have been using the product Yes. I had never thought of asking to see a gynaecologist but would this be a sensible move? I used to use ovestin and vagifem before my breast cancer diagnosis and they gave me comfort and relief. They were a game changer. Then they got taken away. 

J-Nold

Ok, I'm not your doctor so I can't give you advice. Hiprex can be useful but there are some cases where it's not used . I have heard Replens vaginal moisturiser is good - and safe for all.

Definitely ask to see a Gynaecologist (long wait in public so ask early) and get some tailored advice! Another person could be a Women's Health Specialist GP - In Qld we have 'True Relationships' GPs with an interest in women's health not just family planning. And check with your Oncologist about Ovestin as it may solve all the above probs.

Russian_Blue23

Thank you J-Nold for your helpful reply. I am hoping to see my oncologist to discuss use of Ovestin at low dose. I will also ask my GP about seeing a gynaecologist. I do not think we have those specialist GPs for womens health in Darwin but I will enquire.