safety of vaginal estrogens?

[Hopeful]

Just an observation, here: if one of the purposes of using vaginal estrogen is to restore the body's own moisture through cellular health, douching is counterproductive.

Hopeful

[Becky]

Douching is a complete no-no to vaginal health in general because it disrupts normal vaginal flora and fauna and its natural lubrication.

It is the cause of many a bacterial or yeast infection.

Estrogen cream absorption on a thirsty vagina is immediate and great. The trick is lowering the amt of cream used to maintain health versus the amt you need to get healthy.

I went from 2X a week to once a week to now every other week. When tested 6 wks post first use, there was no difference in my estradiol reading vs pre using.

Don't douche for any reason ever!

[RobinP]

Thanks, Becky and Hopeful, being one who has never douched, I didn't realize the negatives aspects of it, and now after googling myself, I realize them. Boy oh boy, another rotten product offered to women- when does it end. You really got to educate yourself, read and read again.

Solution by Becky, thank you,"Estrogen cream absorption on a thirsty vagina is immediate and great. The trick is lowering the amt of cream used to maintain health versus the amt you need to get healthy." For those feeling they can control the cross contamination problem with this method, which seems plausable considering only a small amount is used and hopefully absorbed quickly, perhaps this is a good solution, probably with the best moisturizing results .Again, I'm not claiming any one solution is right for you. Just discussing all this to educate, open options, and let each decide for themself what is appropriate and acceptable.

Now another solution that I have found for those fearful of estrogn creams are natural herbal creams, Replens, vitamin E oil tablets squirted into the target area, soy/flaxseed preparations, etc.- though I don't know the effectiveness of these products, myself. However, a friend on another board swears by REPLENS being helpful. She's estrogen positive and is fearful of any extra estrogen on board. Perhaps using Replens and natural remedies between periodic estorgen cream use may be another solution to help reduce estrogen cream use for those concerned.See link below for mANY VAGINAL NATURAL REMEDIES. http://www.hisandherhealth.com/index...tent&task=view

[Hopeful]

Robin,

I started out with Replens at the suggestion of my gyn, but it is limited in what it can do for those thinning tissues. She admitted to me that estrogen treatment was the way to get them back into health. I have been following a similar course to Becky, starting out with a daub every three days that is now up to bi-monthly (I have to do it on fixed days or else I lose track). In addition, I supplement with Replens every three days. I have found using both to be the most useful.

When I started on Estrace, my gyn had me doing blood work once a week for a month. My base line for ER was below the lab detection level after 6 months on an AI. It went up somewhat after the first week, though never above the level for post-menopause, and came down in suceeding weeks, even as I continued to use it. It leveled out at the end being either below the lab detection level or just above it. My gyn and onc are very satisfied. The gyn explained that as the tissue became re-epitheilialized, it would more readily absorb the estrogen. At the last exam prior to my starting the cream, my gyn could not fully insert a speculum and doubted her ability to collect enough cells to do a pap smear. The exam was uncomfortable this time, but she was able to do it properly, visualize the cervix and do a proper cell collection. This medication is part of my current health plan now.

FWIW, my onc said that he believes the ER levels "bounce around" some on their own without the use of any of these creams, even while on AI's. He rolled his eyes at the weekly blood draws, but I did them anyway. The results gave me confidence to continue with both treatments.

Hopeful

[RobinP]

Excellent approach, HOPEFUL, thanks for sharing, I know it helps alot of us here on her2. ALSO, I appreciate what you posted earlier about methods used to help prevent cross contamination.

[Becky]

Another product that is helpful is RepHresh (by the same people who make Replens). This product is just like Replens but it is buffered and helps normalize vaginal pH. Atrophic vagina due to "menopause" is also acidic. Acidic conditions can also give rise to yeast or other infections so an atrophic vagina is a "twitchy" vagina. Besides the pH being off, there are less vaginal secretions to "wash" away pathogens. I was also subject to this (yeast) and yeast is difficult to get rid of sometimes because adding estrogen can further enhance things. Also, one can be allergic to formulation ingredients (in the estrogen cream/suppository/ring, the yeast infection cream, Replens etc). The usual suspect is usually the preservative but propylene glycol can be a culprit too. These conditions are enhanced by a raw, dry vagina.

If you also have bladder problems, then its worse because antibiotics bring on the yeast (or you can ping pong a bladder infection to a vaginal infection). It can be quite a balancing act to get it all right and be okay. Sometimes the estrogen cream isn't the find all cure and you really have to play around with alot of elements.

It took me almost 2 years to get it all right. I am always on the "edge" but I'm pretty balanced right now. Its helpful to have a great gyne who listens to you and works with you and an great onc too.

[Hopeful]

Becky,

At my last visit, my gyn asked me if I noticed "residue" from the Replens. I told her I did, and she said it was a common complaint. Is there a difference with RepHresh?

Hopeful

[Becky]

Dear Hopeful

When I use RepHresh, I can only use one tube once in awhile (because I am affected by being sensitive or allergic to a common component of these type products). However the gelling agent (Carbopol) is a powder in its natural form (as a chemist I was a formulator for personal care products and this is a common thickener as it forms a clear gel whereas others do not). So, when the product comes out and is on the outside of the vagina then dries up a bit, this could certainly happen (but I do not notice it as I only use 2 tubes a month - but using a tube every 3 days as recommended - one would end up noticing sooner or later). Another problem with Carbopol is that it can also be tacky which is why it usually isn't used in skincare products and only in haircare products (when used outside the body).

[dlaxague]

Dear Becky,

A chemist, huh? I'd never thought about what ELSE is in something like estrogen creams which is odd because I carefully read the labels of things like moisturizing lotion, wanting to avoid parabens. So there it is on my Estrace tube - a long list of chemicals including parabens. However I guess since they are under suspicion for the estrogen-like effects (I think?), their presence in an estrogen cream is less significant. Here's what ELSE is in Estrace:

propylene glycol, stearyl alcohol, white ceresin wax, mono-and di-glycerides, hypromellose, sodium lauryl sulfate, methylparaben, edetate disodium, and t-butylhydroquinone.

And we're putting that inside our bodies. As a chemist, do you see any red flags there, apart from the parabens? Do you think that some of these chemicals have not been sufficiently studied to know if they are safe? At least it's not like lotion, applied daily over large surfaces?

Debbie

[Becky]

Debbie

In parathesis behind each ingredient is what that ingredient does. For the record, estrogen (and all sex hormones) are highly lipophillic (fat loving and water hating). They are waxy substances that are synthesized in the body by further reacting cholesterol.


propylene glycol (humectant - keeps the cream moist and it also is a cosolubilizer), stearyl alcohol(emulsifier), white ceresin wax(emulsifier), mono-and di-glycerides(stabilizers for waterless systems), hypromellose(thickner), sodium lauryl sulfate (surfactant - pretty heavy duty anionic - I am surprised this is in there since there is no water in the formulation. This is the active ingredient in most shampoo), methylparaben(preservative), edetate disodium(chelate - binds heavy metals as it could degrade the estrogen), and t-butylhydroquinone(antioxidant but I am surprised they didn't use Vitamin E).


Premarin cream has no preservative (per se) it uses cetyl and benzyl alcohol that play double duty as preservatives and solubilizers. No chelate (usually metal contamination comes from water - iron, magnesium etc) but it still has the sodium lauyl sulfate and propylene glycol (as well as glycerine).

Damned if you do and damned if you don't! Party on.

[Hopeful]

Wow, Becky, thanks for both posts - very enlightening.

Hopeful

[AlaskaAngel]

When I resorted to using the Estring, it did work well at least for all the "outer" dryness problems outside the vagina, and helped slightly with the dryness in the vagina. Whenever I took it out to change it, if I didn't replace it with a new one right away, every time things went right back to being uncomfortably dry.

But the last time I used it (many months ago) and took it out to replace it, I went for over a month without the vaginal and perineal dryness recurring. However, within a few days of taking it out I still could feel the usual dryness problems elsewhere -- my eyes and ears were painfully dry again and the rest of my skin was very very dry. So I'm puzzled as to why that would happen.

A.A.