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I agree that there's more to the problem than simply lubrication. I think that for garden variety menopausal dryness that might be a solution but when AI's are part of the picture, the solution seems to have to involve some estrogen. I only took an AI for two years but was disappointed to find that after I stopped it, things did not return to normal. "Things" really didn't improve at all. Has that been others' experience?
This is pure speculation/brain wandering - but I've always wondered if it wouldn't be safe to use local estrogen in adequate quantities and take Tamoxifen at the same time - specifically to block any systemic leaking of the estrogen. That's what T does, right? It blocks the estrogen at the level of breast cancer cells. So even if one had moved past Tamoxifen (end of five years or progression), couldn't it still be of benefit in making the use of a little dab of estrogen safe?
My experience is that this problem moves very slowly. It took years before it got bad enough that I had to do something. For me (ERPR -), the first "something" was an Estring. At that time, it had the most information available about actual blood levels of estrogen with its use (slight rise on the first few days, within normal postmenopausal limits after that). It helped and all was good for several more years but gradually things deteriorated again. Now I have estrogen cream, the bioidentical pricey one (gyn thought it was worth it as I guess there is some hint that it might be better/safer than premarin), and I use it very sparingly. And it helps.
This is a hard decision, because there's not as much information as we'd wish for, to make the best decision. I don't know what the best answer is.
It does annoy me though, to read so many articles that claim to be able to help. They are so perky and happy and make it sound so simple - just use some lubricant and maybe some replens and you'll be just fine, sweetie. Argg.
Debbie Laxague
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