Topical estrogen?

Anonymous

Topical estrogen?

gb2115

Hi all...so I started pelvic PT for pelvic prolapse (didn't know it was possible to be so miserable and hate every waking minute of your life), and the PT and I discussed going to urogyn for a possible pessary if the PT exercises don't get it to turn a corner. I haven't been doing the PT for very long yet.

Anyway, I have very unhappy tissue down there, obviously from the tamoxifen per GYN. The idea of inserting a pessary makes me shudder, I can barely tolerate a pelvic exam (why they can't use lidocaine has always been a mystery to me). I'm aware that they often want you to use an estrogen cream. I would happily do this, regardless of increased cancer risk) to feel better.

I wonder if oncology would authorize this? I know GYN would say no (she's generally unhelpful), but my onc is more up to date. I saw research that if you're premenopausal and on tamoxifen, there's little risk from the topicals because theoretically the tamoxifen should block receptors. It's postmenopausal and AI use where it's more dangerous (from what I read)

I'm wondering if anyone else has been down the road of tamoxifen plus topical estrogen?

sbelizabeth

Hi, gb2115. I'm sorry you're so miserable. Here's a link to the ACOG (American College of Obstetrics and Gynecology) statement regarding use of topical estrogen for women who have had estrogen-dependent breast cancer.

https://www.acog.org/clinical/clinical-guidance/co...

Basically, their position is that the first approach should be nonhormonal (creams, lubricants, etc.) If those measures don't provide relief, it's ok to move on to topical estrogen. Your GYN should be on board with this, since it's standard practice guidelines. If she refuses, well, find out why--and if she's generally unhelpful, perhaps it's time to look for a new GYN.

And here's a link to a research project that studied the use of topical anesthetic cream (EMLA) prior to pelvic examinations for postmenopausal women. It states the cream is helpful. I have an old tube of EMLA cream that I used for port sticks during chemo--it's readily available and not expensive. I would suggest you bring this research to your doctor and ask for a prescription.

https://www.ncbi.nlm.nih.gov/pubmed/22417905

I hope your PT is helpful and it turns the corner for you! SB

gb2115

Thanks!! I'm thinking of getting a new GYN. She seems sympathetic to my issues but never offers help. And she's pretty old school, which is why I think she'd disagree on the estrogen. I don't know that for sure though.