atrophic vaginitis and estrogen cream

It's a little like being caught in a game of monkey-in-the-middle....My experience is quite similar to yours.  Except it went like this:  I complained to my GP.  She said talk to your gyno.  The gyno said talk to the oncologist.  The oncologist said:  only if your gyno approves.  Finally my gyno wrote me a script for vagifem tablets, 25iu.  I never quite felt good about it though, it just seems so insane to take tamoxifen or AIs and take all these dietary precautions to reduce estrogen, and then to add it back into my system?  They say small amounts do pass into the blood system...Anyway, I finally told my oncologist, and she was appalled, and said it was not a good idea.  The gyno then said that she thought I was telling her that the oncologist approved.  All this took maybe 5 months.  In the meantime, I had stopped using it.  Currently, my DBF (dear boyfriend) is putting up with infrequent nookie, (this has been three years!!!) but we are making it work, doing other things  I am almost ready to tackle this problem again, by getting a new referral to a gyno who does not just specialize in dealing with pre-cancerous uterine problems.  There has to be something!!!!  I'm NOT comfortable with bio-identicals, because they're still ESTROGEN!!!  It's like saying, "No fructose or sucrose for me!  Just sugar!!!  Lots of it!!"

Looking forward to other posters.... 

Good luck! 

I'm ER/PR+ and on AIs and had the same problem.  I had gotten to the point where intercourse was simply out of the question because of the pain and bleeding.  Lubricants were not doing the job at all. I talked with my gyn and my onc.  While both agreed that I shouldn't use Estrace for the long term, they agreed to a very short term use of Estrace - 3-4 weeks max, 2-3 times a week, and at less than half the normal dose.  My gyn felt that a short course of treatment might just be enough to plump up the tissue to the point where the Replens-type lubricants could take over.  As Otter says, it's a risk, but it's also a quality of life issue. 

That short course of Estrace worked wonders for me.  That was in February, and after a few weeks of using Estrace, things were still a bit painful, but much better.  A few more weeks and regular use of Replens once I stopped the Estrace did the trick.  Things are fine now as long as I use Replens now and then, and a KY type gel.  

My onc said that if the Estrace had not done the job, he would approve a Femring or eString and monitor my estrogen levels, but fortunately my gyn was right and the short dose of Estrace did it.  That may not work for everyone, but I was willing to take a short term risk for the possibility of a long-term payoff. 

I also second Otter's recommendation of checking out the Mojo thread.  I tend to be too shy to bring up stuff like that with doctors, but reading that thread made me realize that I was not alone, and I was right to be angry about having my sex life taken away from me, and I had a right to try to get it back.  It really allowed me to have an open frank discussion with both my onc and my gyn.

Good luck!