Estrace, Vagivem, Etring, Premarin

[MCS]

Calling all users :) Caliing all users :)

Don't be shy or embarrased.

Been reading the other threads. Any changes?

I will be seen the gyn tomorrow to discuss. don't know what to do.

I really would like to use something "natural" to increase my libido and treat my dryness. any suggestions? other than gels, etc. have you tried the ky pills that you insert?

I'm just really scared of using any estradiol creams. I'm hesitant to provoke anything, even though I'm er/pr- ( I don't know the levels though).

But I also need some qol to marital activity

Thank you ladies

xoxo

MCS (maria)

[Becky]

I use estring and I am moderately ER+ (50%) but PR neg. It helps alot but is not perfect (I had my ovaries removed and I am on Arimidex as well).

All my docs say it is very, very safe. My main reason for using this was bladder infections. I was moderately dry (vaginally) but I could cope with that.

Replens and Rephresh (like Replens but helps balance vaginal pH) is also helpful.

[MCS]

Vagifem not vagimen. sorry.

What is most systemic in its absorption? estrace or vagifem?

maria

[hutchibk]

I use estrace, my doc claims that at 1%, it is not strong enough to have a systemic effect.

[Hopeful]

I use Estrace cream. My gyn told me not to use the regular dose, which I think is 4 to a tube, but to use a "daub". I use an amount the size of a pea and apply it with a q-tip every three days. I am ER+ 80%, PR+50%. We checked my estrogen levels for the first month after starting treatment. They went from too low to measure (<50) to 112, then to 106, then back <50, then up to 70 (anything under 130 is considered "post menopausal.). My onc and surgeon are both fine with this; my surgeon told me that her office reccomends this treatment because the UTI's and yeast infections that occur with vaginal atrophy can become chronic and lead to worse problems. My gyn was estatic over the progress I made with this level of application in just two months. I also use Replens; the gyn told me that that will reduce the amount of Estrace cream I need to use to get results. It has greatly increased lubrication and sensation for me (because there is now good blood flow to the tissue) and I have less tenderness and discomfort. FWIW, I am now 53 years old, and stopped having periods at age 45. I was about to begin this therapy for vaginal atrophy when I was diagnosed with bc in April 2006, and it was put on hold for a year. Yesterday, I completed one year on Arimidex therapy, and will continue for 4 more.

Hope this helps.

Hopeful

[hutchibk]

Exactly Hopeful! Estrace has cleared up ALL of my recurrent UTIs... haven't had one in a year. Up to that point I had had about 8 in 6 months...

[Linda]

This is a very real problem! Chemo totally dries you out and makes sex painful, plus the other problems referred to. I use vagifem, and it makes a huge difference. My onc says I can use it as long as I want. I am hormone neg by the way.
Linda

[MCS]

I went to the ob/gyn today.

He recommended Vagifem first instead of estrace. However, he did say that low doses of estrace was ok, especially if you are er-. Just like you ladies said.

He did add that other patients had tried replens and did not alleviate as much. but he certainly said not to try it. I will.

Also other patients had used estring, also with no problems.

I feel like I rather see if the replens works first and then do the vagifem.

I guess the vagifem ( a vaginal tablet) is taken for ten days straight and then 2-3 times a week forever.

In the past, pre bc, I had use progestorne creams and l-agynine. both of which of course stopped in July 2005. Friends had real good results with the progesterone crema- I did not notice antyhing different. The l-argynine did help with mood :) but I have stopped that because again, I'm scared.

Let me know if you come up with anything else.

If and when I switch, I'll post for others to research in future if they need it. As you know, this is our most thorough board for us.

MCS ( maria)

[dlaxague]

My experience after chemo and two years of arimidex:

Replens/lubrication worked "okay" during chemo when dryness became an issue. Then it wasn't enough - probably at about a year out from diagnosis.

Estring, and lubrication, helped for a year or two, during Arimidex.

By about three years out, neither of the above helped at all.

Six years out (I'm patient, or my husband is - and/or stubborn), I said "enough" and my gyn prescribed Estrace cream, which has made an incredible difference. Now, with a little lubricant help, it's practically normal.

I'm ER/PR negative.

Ideas for the libido - how about substituting intention, and patience - lots of it, for libido-as-you-may-have-known-it? Initiate or respond in the beginning simply because you do want things to happen. Take it slow and enjoy the process with an open mind to how it might be different but still good. Like many things after or with cancer - there's probably a new normal and wishing for "like it was" will not serve you well.

It irks me when providers or articles talk about adding lubrication (including Replens) as if that's always enough to solve our problems. It may be enough for some women without breast cancer treatment histories who are experiencing garden-variety menopausal symptoms, but it is not nearly enough for us. How many women give up altogether because they are told that lubrication should fix their problem?

Good discussion.

Debbie L.

[hutchibk]

I can't attest to it, but a "sexual wellness" counselor who spoke to my local young survivor's support group recommended a product called Ixora...
http://www.female-libido-enhancers.info/onlineoffer.htm

I believe it is supposed to be natural in substance, but as I mentioned, I don't have any experience with it. The link makes it seem more like 'Viagra' for women, but she claims that it is better for moisurizing, etc than Replens types of products, which have petroleum products in them.

[kat in the delta]

Will anything enhance or put you in the MOOD... like Viagra for men ?? Has anyone used or heard of others using Testosterone cream to help ??? ....or is premarine..better ??? kat needs.. help..
kat in the delta...

[AlaskaAngel]

In answer to Dlaxague, by informal poll here, which shows that a LOT of bc patients are suffering by this, have not found ways around it, and have discontinued sex because of it:

http://her2support.org/vbulletin/showthread.php?t=27613&highlight=testosterone (http://her2support.org/vbulletin/showthread.php?t=27613&highlight=testosterone)

A clinical trial regarding the use of testosterone for bc survivors was conducted:

http://her2support.org/vbulletin/showthread.php?t=28985&highlight=testosterone (http://her2support.org/vbulletin/showthread.php?t=28985&highlight=testosterone)

A drug that seems to be forever in testing:

http://www.aphroditewomenshealth.com/news/20051002211351_health_news.shtml (http://www.aphroditewomenshealth.com/news/20051002211351_health_news.shtml)

The study of this drug appears to be still recruiting:

http://clinicaltrials.gov/ct2/show/NCT00566982?cntry1=EU%3AFI&rank=37 (http://clinicaltrials.gov/ct2/show/NCT00566982?cntry1=EU%3AFI&rank=37)

Several possible helpful posts here, including referral to info in a discussion at another website for bc:

http://her2support.org/vbulletin/showthread.php?t=24583&highlight=testosterone (http://her2support.org/vbulletin/showthread.php?t=24583&highlight=testosterone)

-AlaskaAngel<O:p</O:p<O:p</O:p

[TSund]

Has anyone investigated estriol as opposed to the estradiol products?

[hutchibk]

Kat - I was initially told to run far and fast from testosterone cream early on... but then I heard about this study in Dec at SABCS... regarding atrophic vaginitis (which is basically the name of what most suffer from, I think)

http://www.medpagetoday.com/MeetingCoverage/SABCSMeeting/tb/7729

[AlaskaAngel]

Thanks for the testosterone post, Hutchibk. I can't help but think it might also help with depression, given the article I posted in the articles forum about it helping men with depression who had very low testosterone levels.

The discussions on the presentation some years ago on Oprah (nothing to do with bc, just women who were menopausal using it because it helped them with libido) and other discussions around that time talked about using testosterone proprionate.

AlaskaAngel

[dberg]

I am ER+/PR+ and posted a similar question several months ago. I was on tamoxifen and the gyn onc I visited was gung ho for me to give premarin cream a try. I was very, very happy because it helped tremendously, but I didn't want to stay on it once I switched to Arimidex. This gyn onc about hit the roof when he heard I had switched to an AI. He doesn't recommend it for women on AIs because there is nothing to block the estrogen that might be systemic, which actually makes sense. But there seem to be other docs out there that don't believe much is absorbed systemically.

I am absolutely desperate. I'm going to seek a second opinion on this because I'm 49 and my QOL is severely compromised by this cycle of pain with sex and then the UTIs that follow.

My blessed and patient husband is uncomfortable with me using any form of estrogen, but for some reason I'm not. I'm so sick of all of this and want my normal, American, roll-over-and-make-love life back. Do I need to be talked down off this cliff and have some sense knocked in me or is any other ER+/PR+ woman as desperate as me?

[Hopeful]

dberg,

I would be happy to have a "normal, American, roll-over-and-make-love life," to begin with! I am ER+ (80%) and PR+ (50%) and I am comfortable using topical estrogen cream (very, very, sparingly, mind you!) for this problem. Here is a link to an abstract that was presented at the SABCS in Dec. '07 that states that this therapy may be fine for some patients taking AI's:

http://www.abstracts2view.com/sabcs/view.php?nu=SABCS07L_684


You can always ask your doctor to give you prescriptions for blood draws to monitor you ER levels - that's what mine did.

Best of luck,

Hopeful

[TSund]

Throwing this out ther again...Does anyone have experience with either estriol or the natural progesterone to address this problem?

[SoCalGal]

Wow - I have been ultra remedial in connecting the dots. BIG changes this past few months. 2 UTI's and funny - the last one felt like it wasn't going away despite 2 rounds of antibiotics. I thought to use some replens on my own - felt irritated and it helped greatly.

DUH - now I realize that I have an ongoing "issue". I also need to find a new gyn as mine retired and moved (he has nerve!). I just didn't connect the dots but after reading all of these posts I get it. I even called my cousin (a leading urologist in NYC) to discuss the lingering feeling of a UTI and the side effects of chemo was not on his radar screen. But it's 100% true - I see it clearly now.

Thanks goils - you again helped me greatly. Now I will find the right cream/lotion/potion/lube:)
xo Flori
PS - Hutchi - I love your new picture of the heart cloud. Did you shoot that?

[Catherine]

Thanks for bringing up the painful sex problem again. I keep putting off making my gyn appointment. Replens seems to help a little, but I need more help. I miss the roll over and make love weekends that were part of our life. (loved that reference someone posted).

I think I will check on the estrace cream first, I am ER/PR negative.

Stay tuned, Catherine

[AlaskaAngel]

This trial appears to have been completed. It will take a while for results to be analyzed and reported, but at least it has been completed.

http://www.clinicaltrials.gov/ct2/show/NCT00630539?rcv_s=02%2F27%2F2008&rank=138