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dlaxague · 07-26-2008, 07:23 PM

Hi Donna and everyone,

I respect "gut feelings" above all else. If your gut tells you otherwise, no amount of evidence or expert opinion can change that knowing of what's right for YOU. But connecting with gut or intuition or "small voice within" - there's the rub. It takes practice and distance from ego to achieve that connection.

Vaginal estrogen does get absorbed. Probably much better-absorbed from vaginal mucosa than from fingers that apply it so I'm not sure how important handwashing is. Skin is a wonderfully absorptive organ but the mucosa is even more-so. The vaginal estrogen that has shown the least systemic absorption is the Estring, but the consequence of that is that it's not the most effective at relieving symptoms, either.

Over time (a few days only), as the vaginal mucosa becomes more normal, more "fluffy", systemic absorption is less. Although they can measure minute systemic increases in estrogen (minooot, not 1/60th of an hour) from vaginal estrogen use, they cannot tell us that there is danger in that. Nor that there is no danger. All they know right now is that there is some small measurable change that happens systemically, and initially, when vaginal estrogen is used. Once again, not enough information on which to base our actions.

And regarding using vaginal estrogen to achieve "normal" intercourse - that is only one reason to use it. Another is to prevent cystitis (bladder infections). Long term, it may prevent or delay issues of incontinence and prolapse also.

So - we lack good research to tell us what is right. This kind of information will take awhile to accrue.

In any discussion of estrogen supplementation by any means, I am reminded of Susan Love's wonderings of long ago - noting that there is a big discrepancy between the level of benefit of hormone-limiting drugs (tamoxifen, AI's, faslodex) and the level of harm of using supplemental estrogen. Her thought was that this might because within the breast tissue itself, aromatase makes more estrogen than we can add with HRT and thus the effect of HRT is minimal (as shown by the big women's health (?-'can't at this moment remember the exact name) study). If she is right (and I think her theory is reasonable), then vaginal estrogen especially for those taking an AI or Tamoxifen would not significantly change the hormonal milieu within the breast. But we do not (yet) know this for sure.

Which brings us back to the gut (or intuition, or small voice within). To access that wisdom, we have to weed out the voices of ego, of fear, and of mind (which are all the same false voice). That weeding is of value regardless - thank you Donna, for the reminder to go for that voice, in whatever way suits us. Pray, meditate, sit in stillness, and get out of the way. Ask, but most importantly, listen.

Debbie Laxague

07-26-2008, 07:23 PM	#8
dlaxague Senior Member Join Date: May 2006 Posts: 221	gut feelings Hi Donna and everyone, I respect "gut feelings" above all else. If your gut tells you otherwise, no amount of evidence or expert opinion can change that knowing of what's right for YOU. But connecting with gut or intuition or "small voice within" - there's the rub. It takes practice and distance from ego to achieve that connection. Vaginal estrogen does get absorbed. Probably much better-absorbed from vaginal mucosa than from fingers that apply it so I'm not sure how important handwashing is. Skin is a wonderfully absorptive organ but the mucosa is even more-so. The vaginal estrogen that has shown the least systemic absorption is the Estring, but the consequence of that is that it's not the most effective at relieving symptoms, either. Over time (a few days only), as the vaginal mucosa becomes more normal, more "fluffy", systemic absorption is less. Although they can measure minute systemic increases in estrogen (minooot, not 1/60th of an hour) from vaginal estrogen use, they cannot tell us that there is danger in that. Nor that there is no danger. All they know right now is that there is some small measurable change that happens systemically, and initially, when vaginal estrogen is used. Once again, not enough information on which to base our actions. And regarding using vaginal estrogen to achieve "normal" intercourse - that is only one reason to use it. Another is to prevent cystitis (bladder infections). Long term, it may prevent or delay issues of incontinence and prolapse also. So - we lack good research to tell us what is right. This kind of information will take awhile to accrue. In any discussion of estrogen supplementation by any means, I am reminded of Susan Love's wonderings of long ago - noting that there is a big discrepancy between the level of benefit of hormone-limiting drugs (tamoxifen, AI's, faslodex) and the level of harm of using supplemental estrogen. Her thought was that this might because within the breast tissue itself, aromatase makes more estrogen than we can add with HRT and thus the effect of HRT is minimal (as shown by the big women's health (?-'can't at this moment remember the exact name) study). If she is right (and I think her theory is reasonable), then vaginal estrogen especially for those taking an AI or Tamoxifen would not significantly change the hormonal milieu within the breast. But we do not (yet) know this for sure. Which brings us back to the gut (or intuition, or small voice within). To access that wisdom, we have to weed out the voices of ego, of fear, and of mind (which are all the same false voice). That weeding is of value regardless - thank you Donna, for the reminder to go for that voice, in whatever way suits us. Pray, meditate, sit in stillness, and get out of the way. Ask, but most importantly, listen. Debbie Laxague