Vagifem

I had frequent bladder infections and vaginal irritation (all attributed to what's called vaginal atrophy, a side effect of estrogen loss.) Sex was painful enough, then I'd get the UTI.

I got on a product called FemRing. It stays in the vagina for three months, emitting a very small amount of hormone to the tissues. It has been a godsend. My oncologist is fine with it, and that's good, because this is a huge quality of life issue for me.

From what I've read, there is an initial surge in estrogen levels when you first use the product. That tapers way off as the tissues become saturated.

I would not be a happy girl without my vaginal estrogen!

Anne

My gyn prescribed Femring for me as well.  I felt as though my wall was paper thin. He said that femring is the product that releases the least amount of estrogen and it pretty much stays local.  It has been fabulous for me.  I've only had it in for about 6 weeks, but what a difference.  I have my appt. with Onc on Friday of this week, hopefully he'll be ok with it.

Girls, can the Femring be used if I have had a hysterectomy ie no cervix to place it around. I am imagining it is literally a 'ring'?

I tend to blame my breast cancer on Vagifem which I used for 5 years. There is no history of breast cancer in my family.  I noticed the warnings on the Rx were getting stronger & stronger about the possible connection of breast cancer & Vagifem.  Everytime I talked to my gyn. she said that very little estrogen got into my bloodstream & that I should continue using it.  Have had mammos every year. Seven months after my last mammo they found breast cancer. Oncologist said there is no way of telling what caused my cancer but I no longer take Vagifem.  I'm using over the counter Replens & /or KY gel inserts.  They are not perfect but relieve some of the discomfort.  I also took over the counter Extra Strength Estroven to help with hot flashes.  It is just vitamins and herbs that did help but dr. said that the quality of the ingredients are unknown & that sometimes the black cohash & soy interacts with other things in the body to increase estrogen.

I just did a google search on using vaginal estrogen after having estrogen receptor + BC, and this thread popped up:) I am wondering  what info I can get about this  from this knowledgeable group of women. I had a hysterectomy and oopherectomy about 5 years ago and found vaginal estrogen so helpful. My oncologist told me to stop, but my friend sees his partner and he told her it was fine. So I'm guessing this is one of those issues on which there is disagreement.

I'm on an estring and it's been soooo helpful.  I'm ER+/PR+, but I found a research paper that showed that the maximum amount of estrogen released in the system from an estring peaks after 2 weeks, then calms down to the point where 8 weeks later any increase is barely measurable.  (I'm going from memory so the number of weeks might be off a bit, but that was the gist of the article.)  The theory is that the vaginal tissue is very dry when you first start using the estring, and it absorbs a lot of estrogen (think of that first coat of primer you put on raw drywall) but once the tissue "plumps up" it absorbs a lot less (think of that 2nd-3rd coat of paint on that same wall and how much less paint you use).  Unfortunately, I lost the citation to that article so I can't give you the link.  But my onc said basically the same thing.  But I had to search long and hard to find that article as this whol area has not been well-researched, so I think that's why oncs are so divided on the issue.

As with everything, it's a calculated risk, but QOL issues are important.  FWIW, I've had two different oncs in two different practices give me their blessing to use an estring given the severe vaginal atrophy and QOL issues I was having.  

I never used vagifem, estring, or anything like that and still got b/c, so who knows what caused any of us to get it.  Plain dumb luck? 

Amy - as MOTC says, you may want to check with your onc about an estring rather than vagifem.  

This forum has been very helpful. I have severe dryness and atrophy due to my chemopause. Gyno suggested I speak to Onc about vag estrogen because of QOL issues. According to him, as long as I am taking tamoxifen, I can use Vagifem. After 5 years, I'm on my own.

I have been on Vagifem since before my ER+ breast cancer diagnosis (I had been through a hysterectomy/oophorectomy and hence was post-menopausal). My oncologist at a major Harvard teaching hospital said the amount of estrogen released was negligible and she was fine with my staying on the Vagifem. 

It's now been seven years since my diagnosis and I'm still using Vagifem. Otherwise, I have extreme vaginal atrophy, including even painful bumps in the vaginal area, plus urinary tract infections, and intercourse was extremely painful.

Just the other day, when I filled my prescription, the pharmacy notified me that the current dose of Vagifem will no longer be available. Now, instead of 25 mcg, each dose will only be 10 mcg. Years ago, I read that the 10 mcg dose was available in Europe, but until now I wasn't aware that it was available here. I assume the dose reduction means that the 10 mcg dose has been found to be sufficiently effective, so that the higher dose isn't necessary.

My PCP just wrote me a prescription for the new lower dose and I'm looking forward to trying it. Even though the amount of estrogen released in the 25 mcg dose is very small, I'm delighted to use even a smaller dose if it's effective.

mcgaffey, have you ever considered Vagifem or E-string? I believe they're considered to be less likely to enter the bloodstream than estradiol cream, while still providing excellent vaginal and bladder relief.

Barbara

Barbara, I don't use estradiol, I use estriol. A difference. I can't get vagifem where I live. I can't even get estriol. Recently, I have had to fill prescriptions in England. Hopefully, they will start to import again into my tiny country.

I live in Cyprus. I believe estriol is weaker than any estradiol products. My sister in California is using the e-string I believe. She had cervical cancer and the docs can't even take scrapes to see how she is doing without her using some estrogen cream. My gynecologist says what I am using is very localized. But then, who knows. I am sure it has an effect. And the effect that I can experience right now is beneficial. I just won't live without vaginal estrogen treatment of some kind. I am trying to keep it at a minimum. I never used any estrogen therapy pre-breast cancer because I knew I had a history of breast cancer in my family. But that didn't seem to help me. By the way, I am 63 and 3 1/2 years out. Thanks for the response.

Just found this thread again.  I can't live without my Vagifem.  I used the 25 dosage before BC and now I've just started the 10 MCG and it makes such a difference...like having intimacy or not!  I feel that the amount absorbed systemically is negligible and it is a huge quality of life issue for me.  My Onc said NO!  But when I saw my female GYN she completely understood and prescribed it for me.  Then, I went to refill it, and guess what.  My Onc had cancelled the refills!  I'm SO angry.  This should be my choice and my risk to take!  Alison

BTW, does anyone use compounded Estriol Cream instead and how does it compare to Vagifem?

Pixelpup, how is one doctor able to cancel another doctor's prescriptions?  And I agree, this should be your choice, especially since you have a doctor who said yes to it.  Maybe you can get a renewal from your Gyn?

Hi Pixelpup,

I am amazed that a doctor can override another one. I didn't tell my onc. about being prescribed vagifem by my gyn. However, I was somewhat afraid to use it and in the end went with my naturapathic doctor's advice and took E3 instead. The E3 isn't as convenient to use i.e. it doesn't come with applicators but I feel comfortable using it instead of the vagifem. The ingredients are whipped cocoa butter and bees wax with plant derived estriol and vit. e. The estriol is supposed to be the good estrogen as opposed to the estradiol in the vagifem.

My surgical onc, medical onc, and gyn all conferred and discussed if I should use Vagifem or not.  Gyn provided enough updated indepth  info to the oncs that they are comfortable with my using Vagifem.  Very, very little of the estrogen is released into the body.  Vagifem has made a big, big difference for me and I would be hard pressed to give it up. 

My Onc prescribed the Vagifem for vaginal dryness, he said it was safe to use as very little oestrogen is absorbed in the blood and QOL issues are important. I had to stop Arimidex due to worsening osteoporosis - I'm only 41, but my blood estridiol level is very low even without the Arimidex form being in menopause from the Chemo so he is happy for me to use Vagifem. It has made a big differnce to the dryness and atrophy