Alternative to Estradiol?---

sflow · January 2010

I have been on Arimidex for 3 yrs for ER + early stage breast cancer. I am well past natural menopause. Lately I have been having symptoms of "vaginal atrophy". I have heard doctors like to prescribe Estradiol or other derivatives of estrogen--obviously I don't want to take those since I am ER+. Any alternatives out there--I am miserable!

REKoz · January 2010

I admire you for being able to do the Armidex for 3 years already!! Kudos to you. It only took 5 months of Aromasin for that se and many others to really ruin my qol! The vaginal issue was second only to depression. Even if I overcame my lack of desire, it became physically impossible for sexual relations. Been off for 2 months and am awaiting the results of the Tamox. metabolizing test. If I'm a go, I'll give that a try. Onc. thinks it could be better as you don't lose all your estogen. He said if I am having the same troubles, he would feel OK with my using topical estradiol (minimal amount) on Tamox rather then an AL. Maybe you want to ask your Onc about this. I am post menopausal as well. We will see...I'll be thrilled if it works out but if not, I am going on the bioidentical hormone train.

Best of luck to you.

Ellen

Good luck to you.

hlth4513 · January 2010

You might want to ask your onc about estriol. My onc is extremely conservative and yet she suggests vaginal estriol along with ARimidex for vaginal dryness. I opted out of the ARimidex, but twice a week on vaginal estriol has taken care of my issues.

Beth

vivre · January 2010

Have you read Dr John Lee and other doctors books about hormone balance? It is not just that we are estrogen dominant that is the problem. It is the fact that we are not producing other hormones, such as progesterone that causes problems. I have refused all hormone blocking drugs. I instead, I have found a doctor who specializes in hormone therapy. She tests all my hormones, including my thyroid, and has helped me to balance everything. Onc's do not know a thing about this. They only know about the blockers. Taking tamox increases your risk of uterine cancer and blood clots. Recent studies also show that women are more likely to end up with more agressive cancers after tamox. I have lowered all my estrogen levels with better nutrition, weight loss, and supplements such as iodine and myomin, which has been proven to change the hormone ratios just as well as tamox. And the only side effect I have is that I feel great. No joint pain, no depression, lots of energy, and peace of mind.

Springtime · January 2010

I also have these issues and have read Dr. Lee's book, What your Doctor May Not Tell You About Breast Cancer. In there I learned that what Beth says is true. Estriol is a safer estrogen and apparently not associated with BC. Estrodoil, however, is the bad one and is associated with BC.

I do NOT understand why things like EString and other Vag estrogens (VagTabs?) use Estrodoil!!! My only thought is that is is easier and cheaper for them, or else they have not a clue.

I think you would need to get Estriol from a compounding pharmacist.

Beth, where do you get your Estriol? did your ONC write you a perscription? You are lucky to have an ONC that is so progressive!! How much to you use, and how often? if you don't mind me asking.

hlth4513 · January 2010

Springtime-

I am chuckling that you think my onc is progressive. I was shocked that she actually suggested the estriol, but she is the one who also told me not to go to spend any time on the INternet and who told me what I eat doesn't make any difference.

My onc didn't write the script - but I think she would have - although I don't know if her script would have been for bioidenticals. I was already working with a Nurse Practioner(who works with an amazing compound pharmacist) who does bioidenticals and she wrote the script. The script called for using it daily for two weeks(I just did daily for a week because it worked that quickly) and then 2-3 times a week as needed after that. I use it twice a week. It is prefilled into individual applicators so it is premeasured.

I didn't test my EQ ratuio before starting - but I do have a 24HR Estrogen Profile Urine kit en route right now so I will be able to see what my ratio of estriol compared to estradiol and estrone is now.

Beth

Springtime · January 2010

Beth, wow, pre-measured? does it have a (sort of) applicator too? i am so surprised, I figured it would be in a little pot or tube and you'd have to guestimate...

screw that internet comment! And you're right, she may not have given you bioidenticle...

hlth4513 · January 2010

Springtime-

Yep it is in a syringe type plastic applicator - just insert and push.

I know that the compound pharmacy ships all over. He is actually on Long Island, NY and I am in Sarasota, FL. My nurse practioner practices in both Sarasota and the Hamptons, but I have found the NY compound pharmacist really helpful and more reasonable than the one I was using here. I know that he has also conducted seminars on Breast Cancer in his area and was really helpful to me when I was in that crazed beginning stage of trying to figure it all out.

BTW - I got three months supply at a time and saved a lot of money.

Beth

rgiuff · January 2010

Beth and Ellen, I live on Long Island and would love to find a Gyn who would give me bioidentical estrogen for the vaginal area. Believe me, if I could find a doc who would prescribe complete bioidentical hormone replacement, I would go with it, even I was ER/PR+. I've resigned myself to the fact that the best I can probably expect to get is a vaginal estrogen product. But since this is the area where most of my complaints are, I would be happy to get that. My current Gyn is reluctant, keeps saying "Oh tamoxifen causes discharge, so you shouldn't be having dryness issues." But I'm also feeling that the skin is thinner down there and now my bladder suddenly seems to not be holding urine as well as it always did, and any stimulation down there is lately making me feel very raw, even along with the frequent vag discharge, so I think it's time to get something. Beth, could you tell me where your compounding pharmacist is? Maybe through them, I could find a GYN who would be willing to help me out.

vivre · January 2010

Rose, my doctor is a part of a group of doctors who specialize in hormone therapies. They are nationwide. check out bodylogicmd.com Also try to find a compounding pharmacist. They usually have a list of doctors who understand bioidentical hormones.

hlth4513 · January 2010

rguiff-

I am not sure if it is proper etiquette to post their names. I will PM you with info.

Beth

hlth4513 · January 2010

rguiff - can you please PM me and I will reply with info - I am having trouble getting my PM to you.

Thanks,

Beth

Anonymous · January 2010

sflow ~ My gyn prescirbed "Vagifem" for my atrophy. She said it is very low dose and would not affect me even though I am ER+ . It is applied with an applicator twice weekly and she told me to use "Replens" for the dryness. It worked out awesomely and I have had no problems since. Also it made a huge difference for my sex life. Replens works great now that the vaginal tissues are ot atrophied anymore.

sflow · January 2010

Thank you Shanagirl--will ask my gyno about that.

Springtime · January 2010

When I looked up Vagifem on the Web, it stated it was Estadiol. That is the dangerous estrogen that has been linked to cancer. Same as Estring. Estriol is safer. Just saying. I do not know why these companies are using Estadiol!!!!

I tried Replense but it was not enough. I need something else and am going to work on getting Estriol for vaginal atrophy. Beth, if the local compounding pharmacist does not give me an applicator, I will PM you for info on the place you use!!!

fairy49 · January 2010

I asked my naturopath to give me some vaginal estriol, she says she can't because this is all so controversial, she says many won't prescribe us anything like that for the fear of being sued, we all knew that anyway! I am so flippin frustrated!!!! She did say to ask the oncologist if it was ok, of course he's going to say NO! She was funny though, she said that he probably wouldn't know the difference between estriol and estradiol, pretty scary but she's right!!! I have seen two naturopaths now and noone will give me estriol!! F..ck!!!!! Yell

anondenet · January 2010

I'll PM you with the name of a very well-respected doc who has a practice near-ish to you. He has also published for years on this subject.

Not to worry Kiss

thenewme · January 2010

Bio-identicals: Sorting myth from fact

Myth: "Bio-identical" hormone products that contain estriol, a weak form of estrogen, are safer than FDA-approved estrogen products.

Fact: FDA has not approved any drug containing estriol. The safety and effectiveness of estriol are unknown. "No data have been submitted to FDA that demonstrate that estriol is safe and effective,"

FDA has not approved any drug containing the hormone estriol. Pharmacies should not compound drugs containing estriol unless the prescriber has a valid investigational new drug (IND) application. INDs provide benefits that include allowing physicians to treat individual patients with drugs that are not FDA-approved, while also providing additional safeguards for patients.

mollyann · January 2010

Sounds like another FDA Church Lady declaration. LOL.

fairy49 · January 2010

Thanks ANOM!!!! Kiss

thenewme · January 2010

Hi Mollyann,

Do you have anything helpful to add to the discussion? Any facts to demonstrate that estriol is safe and effective?

Signed,

The Church Lady

Anonymous · January 2010

Church Lady,

Seriously. You need to read more carefully. Did you see me make any claims about estriol?

I was asking for documented evidence against estriol from the FDA.

Do you have any evidence on humans that estradiol is harmful?

PS, evidence is not defined as "the FDA says so." We would call that gossip.

Springtime · January 2010

Well, my GYN said she would give me a perscription for EString when I was a few years out (not right now, it's too soon). She said it is a very very low amount, and she feels a quality of life issue. She said it really really works which is what you hear here.

Lorraine, did you ask your OB/GYN? This is insane! 2 Neutropath's won't give it to you?????? What good are they !!! For pete sakes.

Of course at the time, I did not know difference between Estradoil and Estriol, and would never use EString because it's the bad Estrogen. I am going to ask my Osteopath.

Yazmin · January 2010

Springtime: EString, isn't that Estradiol, though?

Springtime · January 2010

Yes!!! It is Estadiol!!! As are the VagTabs. Best to avoid them! I bet my GYN doesn't even know. Why is everybody so clueless I wonder? sigh.

rgiuff · January 2010

I'm going to ask my Onc on the next visit if he will OK it. Being that I'm on tamoxifen, he may feel that I have that to protect me against any extra estrogen. I think I want the cream though, because I need it on the outside almost more so than the inside! And isn't the estrace estradiol bioidentical? That is the one my Gyn prescribed for me before the BC diagnosis.

Another question. I believe I've seen the estriol available online without a prescription, can this be possible or is it likely not the real thing? I'll try to find the site where I saw it.

mathteacher · February 2010

Rose, did you ever find estriol online?

katgirl · February 2010

I posted on another link but just found this one. I struggled with the decision to take Estrogen as I was ER+ but decided the benefits for me out-weighed the risk and symptoms I was experiencing. So, my GYN said use a small amount of Estradiol and said Bio-Identicals were extremely dangerous. My NP doctor said the one my GYN gave me was part of the many law suits and was similar to what I was using before BC, and dangerous. I decided to go Bio-Identical and already feel better. I've suffered from constant bladder infections, insomnia and atrophy just to name a few symptoms.

Kat

MsBliss · February 2010

thenewme:

Estriol was pulled from availabilty by a lawsuit from Wyeth, the makers of Premarin and Prempro. These are the same people who manipulated the numbers in the studies so they wold not reveal an increase of cancer, stroke, heart attack and dementia from the use of these products. These are the same people that have lost their cases in court and sealed the records. They don't want women using anything but the horse estradiol.

The 9th circuit court overturned Wyeth's petition to stop sales of bioidentical estriol in that district. Estriol is available through pharmacies in that district only. Estriol was shown in court to have benefit and medical value.

Estriol and 2 methoxyestradiol are protective and non inflammatory. Once Wyeth can patent these molecules, they will promote them with the same zeal that they did with premarin and prempro.

Now that sales of premarin and prempro have declined, the horses that were used for it's production, in horrid tortured conditions and foals sold for slaughter, are "unemployed" and being sold to slaughter houses. No provisions were ever made by Wyeth, who made billions and billions of dollars in this business of cruelty, to provide any form of placement or retirement for these abused creatures.

MsBliss · February 2010

in response to thenewme re estriol's validity as a therapeutic agent:

Estriol is natural to the body.

Why does someone have to tell my body it belongs there? Why do I have to go to court to get it?

Because pharmaceutical interests want me to use their twisted version of estrogen and not what is natural for the human body.

thenewme · February 2010

Hi MsBliss,

It seems that you may be confusing facts with histrionics. I feel very strongly about some of Wyeth's actions, too, but have you actually read the Wyeth citizen petition regarding BHRT, as well as the FDA's response? Which part, exactly, do you object to? From what I understand, estriol wasn't "pulled" - rather it had never been approved, even before Wyeth became involved.

I was unable to find a source for estriol being available in the 9th circuit district - can you share you source? I'm interesting in reading more about this.

Estriol is natural to the body. However, supplemental (exogenous) estriol has evidently not been shown to be safe and effective for the uses it's being prescribed for.

Here is an interesting article that clarifies the FDA stance on estriol:

http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/PharmacyCompounding/ucm183078.htm

From that article:

************

FDA has streamlined the IND process for estriol to make it as efficient and convenient as possible for practitioners, while still maintaining patient safety.

Under this streamlined process, FDA is willing to accept INDs covering multiple patients, on behalf of multiple health care providers, and for a range of doses. The general requirements for practitioners filing an IND application for estriol are:

* Completed FDA Form 15711

Drug formulation and chemistry information including:

* Names and addresses of the pharmacies making the drugs
* Attestation from the pharmacies that they will use only USP/NF grade ingredients and adhere to USP processes and procedures when preparing the compounded products
* Detailed description of the drug formulation that will be used (ingredients, quantities, and production processes)

Clinical information including:

* Number of patients
* Types of symptoms that will be treated by the drugs
* Dose ranges for each formulation
* Monitoring procedures, including safety monitoring
* Copy of current medical license of the practitioner

*******************

It's beyond my comprehension why anyone would NOT want these safeguards in place for any supplement they would be taking, particularly someone with comorbidities such as breast cancer.

I'm all for individual freedom of choice, but I also feel strongly that manufacturers should be required to be upfront and honest with their claims, so that consumers can make decisions based on solid facts. Of course I'm talking about manufacturers and retailers of conventional and alternative products. The standards should be the same.

Alternative to Estradiol?---

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