Opinions --Vaginal Atrophy

[Yorkiegirl]

I haven't had a problem with this issue in the past,but am now having lot's of problems.

I saw my Onc today for my 3 month follow up. I brought this issue up. I asked since I was ER/PR Negative would it be ok to use a Estrogen Cream. I know all the Pro's and Con's of the issue.

I am now 3 years out from original DX.

I am being scheduled for a PET Scan and Brian MRI ( having cognitive issues).

After getting these scans done, and hoping that they both are OK, would any one consider using the Estrogen Cream?

I have to do something about this issue as I am having such horible pain with dryness.

Thanks for any opinions.

[harrie]

Yorkiegirl, since you are ER/PR neg, I presume it is safe for you to use an estrogen cream. Well you are in luck my girl! I've tried this and it works WONDERFULLY with a bare minimal amount...it is Premarin cream. I had the same problem with dryness and thinning of the walls of the vag canal and sex was NOT comfortable (downright painful sometimes!) unless I was VERY turned on! So my obgyn suggested this premarin cream and it totally solved my dilemma! I only used 1/2 the recommended dosage and maybe once or twice a wk only and it worked very well.

[hutchibk]

York - check out this thread from a couple weeks ago...

http://www.her2support.org/vbulletin/showthread.php?t=33898

[Yorkiegirl]

Thanks MaryAnn and Brenda for your responses.

I was looking for that thread and couldn't find it. At the time I didn't read much of it,as I didn't think it applied to me, boy was I wrong.

I guess I will wait until my scans are done and go from there.

Thanks again.

[Becky]

I also have the problem too and used estring but now just use 1/4 g of Premarin cream once a week. However, Jean's new ob/gyn suggested a drop of olive oil just on the outside (outside only) for discomfort in sitting etc. It works well - not for intercourse or anything but on the outside - some highly hormone + women can't use the estrogen cream and sometimes the outside gets bad that you can't even sit.

So Vicki - you can do this to the outside until you get the 2 thumbs up and get the cream. Don't put it inside - just outside!

[harrie]

Question for anyone:
If a person is ER/PR negative, wouldn't it be considered safe to use estrogen based products such as Premarin Cream?

I think it is always wise to weigh the risks to quality of life. Sexual relations can be a very significant part of one's relationship and quality of life.

[Jean]

To add to this thread:
On my recent ob/gyn visit had discussion on this topic with the dr. She stated clearly that it is important to
keep the blood supply going as lack of blood supply will
also create vaginal atrophy. I guess we could say,
"If you don't use it - you lose it"

Jean

[Yorkiegirl]

HMMMM Jean it's little bit hard for me to use it, since my hubby is oversea's, but I would like to use it when he's home. LOL

[Hopeful]

With regard to blood supply, there have been tests with Viagra that show that it also helps the blood supply to the female organs (though it does not help with libido, etc.). I considered it, and my gyn and onc were ok with it, but I decided against it. When I get back to where my files are, I will edit this post and add a link to some of the articles I found.

Hopeful

[hutchibk]

Here's a good link that helps answer the original question posted:

http://www.susanlovemd.com/breastcancer/content.asp?L2=5&L3=6&SID=132&CID=610&PID=0

[R.B.]

Yorkie Girl

Cognitive issues.- Good luck with the scans


On a more general level

Women have as many neurons as men but in less space.

Neurons and brains have an essential need of long chain Omega 3 DHA.

Women make more DHA than men by a factor of ten.

Fat disturbances are often seen in brain related conditions, ADHD, bipolar depression alzheimer's etc. In general terms trials suggest long chain Omega 3s are protective.

Oestrogen promotes DHA production from the mother omega 3 in women. It may be that the more severe depletion of oestrogen due to treatments has a greater than normal impact on the production of long chain fats.

(Maybe fat conversion trials and testing should be done on women taking oestrogen blockers to see to what extent conversion is impacted and if this extends to Omega 6s too - although Omega 6 is more easily converted and the mother fat is usually present in large amounts in the western diet)

Women are more susceptible than men to DHA deficit and this is evidenced in high levels of neurological conditions with age.

So its back to the importance of Omega 3s and considering supplementing DHA with fish oil, oily fish, or vegetarian supplementation.

http://her2support.org/vbulletin/showthread.php?t=24410&highlight=greek+diet+thread

Please discuss dietary change with your doctor. Omega 3s can have issues for some.

(I will post a link to my new web site and book next week. The book will be available in a week or so)

RB

[Vic]

Hi RB,

I'm about ready to go to the health food store and buy some fish oil capsules (looking at NutriCology, Nordic Naturals, Natural Factors or ResQ1250...I wrote an email to each company) and today I noticed your message about issues that can arise with Omega 3s.

Can you please explain and do you know the RDA on these as they are all so different when comparing labels.

Thanks,

Vicki

[R.B.]

Hi Vicki,

This is a good thread. Dont worry if you do not understand the technical stuff you just need the gist.

http://her2support.org/vbulletin/showthread.php?t=24410&highlight=greek+diet

The other half of supplementing Omega 3s is to balance the omega 3 and six mother fats. Mother omega 3s and 6s are the ones found in vegetable oil sources.

I am a researcher a best. I am not an expert and not a doctor.

There is considerable discussion on dosages of fish oils. There is no right answer. It is complex. You need to talk to your doctor. My instinct would be towards the higher rather than lower end of the recommendations. Oestrogen plays a role in allowing women to make more long chain fats like DHA. So do those on oestrogen blocking strategies have a significantly lowered ability to make long chain fats. My guess is yes. IF this is the case then such women would arguably have a higher need for long chain Omega 3s, and maybe an higher need than average post menopausal women.

Definitive answers to the questions do not exist, but as the risks of reasonable omega supplementation for most are very limited and the potential benefits high it would seem a reasonable risk reward decision to go for the higher end of the normal recommendation range. Against that there are only so many fish.

There are some very good bottled oils which is a cheaper way of getting the same amount, but some prefer capsules.

If the Omega 3s and 6s are in balance it may be that lower intakes levels are fine, but the reality is the answers are not known.

Total EPA plus DHA recommendation vary from about 300grams a day to 2.7 grms a day.

This is a good book by a renowned doctor and neurosurgeon that does look at potential issues of fish oil supplementation, and it is not too expensive. The risks are limited but there are issues with some medications etc, and different doctors have different viewpoints, so best talk to your doctor about it.


Dr Maroon seems to be heading to a gram a day but you will see others in the link are suggesting up to 2.7 grams (about).

Fish Oil: The Natural Anti-inflammatory (Paperback)
by Joseph C., Ph.D. Maroon (Author), Jeffrey Bost (Author)

http://www.amazon.com/Fish-Anti-inflammatory-Joseph-Ph-D-Maroon/dp/1591201829/ref=sr_1_1?ie=UTF8&s=books&qid=1213134012&sr=8-1

[MCS]

Well, I went to my obgyn today. I'm so dry and thin in the vagina that the doctor said to use the vagifem. I didn't use it last time he told me to- sept 07.

I'm scared that I will get the one dose that does the bullet and get absorved in the blood. I am ER- and my estrogen levels are very low. both the obgyn and onc has said that it would be ok for me to use it

Does anyone know what happens if the wall is too thin? other than of course painful sex and a little bleeding? Am I risk for something worse if I don't use it?

they did advice against estrace cream since it does get absorved in the blood


thank you

maria

[harrie]

RB,
How difficult is it to know if the foods I am consuming are in fact Omega 3 and 6 balanced?
It isn't something listed on the nutritional label, correct?
Maryanne

[R.B.]

Hi Harrie,

Vegetable oils are used to some extent in some form in most processed foods. Labels do not list the Omega 3 and 6.

Grain fed animals likely the same imbalances as we have, which adds to the problem.

They also breed low Omega 3 grains and take Omega 3 out of oils as processed foods will keep longer.

As the most commonly used oils are high in Omega 6 and industrial processing takes out Omega 3 then most foods with vegetable oils will be high in Omega Six depending on the amount used.

We are seeing that in Omega 6 in the body fat which has increased very significantly in the last 40 years.

One of my cries is for better labelling.

This a useful site.
nutritiondata.com

Others are listed on my resource page.

http://www.omegasixthedevilsfat.com/resources.aspx

[harrie]

R.B.
Since it appears to be difficult to avoid the Omega 6s and the foods with a good supply of O3 are not as abundant, do you know if there are supplements available with the recommended ratio and then I can just pop the pill on a daily basis and at least know I am getting enough of the Omega 3?
Normally I eat a lot of fresh fruits and vegtables and not much meat and rarely foods cooked in a lot of oil. Fish is very abundant over here, but I don't really like it all that much. It's ok...but not something I go out of my way to eat.

Also R.B....I know this is something out of context....but I remember you mentioning the 6s. That number bothers me. It is prob just in my imagination, but when I see it too often around, I feel like it is a bad omen. I love the number 1 and when I see that number, esp 11s, I feel really good and safe. Lately I have been seeing more 6s then 1s and that is NOT a good feeling when one is out of chemo and paranoia is sometimes a thorn in my side if you know what I mean.
Please, don't feel you really need to respond to this numbers thing. I am just venting here and just call me crazy...thats fine too!
Muchas alohas,
Maryanne

[R.B.]

As you observe Omega 6 is everywhere in processed foods.

You need to look at whatever your oil intake in terms on its composition. `Not a lot' is different for different people.

There are a number of people that market a 3 -6 -9 oil with reasonable Omega 3;6 balances of the mother fats. Cold pressed under inert gas is likely to be best. But if you already have lots of Omega 6 in your diet then the 6 in a 3-6-9 oil will add to that balance, and oils with more omega 3 like flax may be a better choice.

Even if you a getting the mother omega 3s a number of factors can prevent conversion to long chain fats DHA and EPA, so the most certain option is to ensure a supply of long chain Omega 3s in fish oil or vegetarian sources. How much - 600mg to about 3 grams a day of DHA and EPA combined total are suggested in trials. Oestrogen facilitates conversion, so loss of oestrogen likely diminishes conversion. So my inkling would be towards the higher end of the spectrum. Some take more. Please talk to your doctor about dietary change.

Numbers - The book was called the Omega Six the Devils Fat as Omega 6 arguably promotes the seven sins by influencing behaviour through the chemical pathways, and the fat is made of 18 carbons divided into groups of 6 by the position of the double bonds - 3x6.

It just seemed a catchier title than `Omega Six in excess may increase the risks of a number of western conditions or similar'.

Number theory is fascinating, but more than likely much too subtle to have simplistic observable effect. We all have our favourite numbers.

Omega 3 DHA is essential to brain function and reduces the risk of a number of neurological conditions.

It is not something I have found much on, but I have often wondered if chemo uses the body's stock of Omega 3s