Anastrozole use and Premarin Cream for vaginal dryness

ccar69

I am 69 and married.  I had a lumpectomy to remove a .9 cm low grade tumor, followed by 3 weeks of radiation.  Tumor was Estrogen +.  I have very bad vaginal dryness making intercourse too painful to have.  I have differing opinions of the safety of using premarin cream.  Onc. says too risky, gyn. says amount of absorbsion is minimal.  Anyone with a similar situation?  I have tried lubricants, even vasoline.  I was allergic, and still had bad pain.  

MEG2

ccar69... I am ER+ and an anastrozole user as well; I've had terrible dryness along with itching and redness, all very uncomfortable. My Doc recommended several over the counter options; coconut oil or olive oil (yes...) but those are really only at home remedies (i.e. greasiness), sort of like Vaseline. Coconut oil worked best for me, perhaps one of these may be helpful? I also use Replens as well. I've also been told that any hormone replacement cream or pill is not an option. I am not married and a bit younger howerver, do anticipate an intimate relationship at some point. Bottom line question I asked my Onc was is this a use it or lose it situation...her response was yes. So basically having sex is a good thing, it will keep away atrophy...but one has to deal with pain and/or pain management. At this point my Onc recommended a "dilator" (read that as you will) that helps to stretch the vagina/vaginal wall so that sex is less painful.

Not sure if any of this will be useful for you or not but perhaps another conversation with gyno or onc to approve or disapprove any new ideas is in order. I was also prescribed a steroid, betamethasone that really helped with the redness and itching situation. Not sure that would cover any pain issues and can only be used sparingly but if you need some relief that may help as well. I've found this topic isn't discussed much on these boards or else I am missing out on the conversation. I wish you the best in resolving your issues.

nonetheless

ccar69,

I'm not using anastrolzole or any ai or hormone drugs so I can't speak to the effects of vaginal dryness from them. But I did start reading posts in the Sex Matters section of these discussion boards because of wanting to learn more of what works for women with worse dryness than I have. And I saw a number of interesting threads that I made note of in case my dryness worsens to the point of needing to try something. So you might want to look at some of the suggestions posted there if you don't get much response here.

I had been on HRT for several years prior to my DCIS discovery last month. Even the estrogen patch didn't entirely prevent my dryness. But so far I get by with a lube product. I didn't tolerate the premarin cream because it caused headaches.

leenso52

My gyn also said the amount of hormone that is actually absorbed systemically is quite small. But as an alternative, she suggests coconut oil! Organic, preferably. Just a tiny amount. I do not have a partner anymore so I'd love to hear if it works!

MaineRottweilers

My situation is not the same but it is similar enough that I thought I would tell you my experience. I am not ER+ but I am PR+ and Anastrozole is recommended for me but first I must finish chemo. I was experiencing my second chemo induced menopause (I am metastatic). The first time, before I was metastatic and we were going for cured, I was denied Premarin cream, my MO said it was too great a risk even though I was ONLY HER2+++ and Tamoxifen was not going to be prescribed after chemo. Intercourse was excruciating but I knew it was only temporary.

Once I went metastatic and again entered chemopause with excruciating intercourse which we knew would be permanent due to either chemo or AI, I insisted for QoL and my MO complied. Two weeks of application and I was able to have mildly uncomfortable intercourse. After three week, it was almost pleasurable again. I took a week off (as prescribed) and started applying again every other day (my own doing---not physician suggested) and I am still experiencing improvement. I am going to move toward using the lowest possible application dose and frequency. This medication is very expensive but has put some quality back in my life ---very worthwhile. If you are not stage IV or metastatic, it's probably not worth the risk if you can find other alternatives but ultimately, it's your QoL that is important.

Jelson

There are two other forums on BCO discussion boards that have many lively and informative threads on the topics of vaginal dryness, pain and atrophy, one is Hormonal Therapy Before During and After https://community.breastcancer.org/forum/78 and the other is Sex and Relationship Matters https://community.breastcancer.org/forum/150

I am heading over to Sex and Relationship Matters to learn what is new about dhea!!