Hi Raelan, Good for you! I did 2 and think it helped with the incontinence and the dryness, but still want to go back for the 3rd and a possible 4th treatment. I will update too, and will be interested in seeing your progress.

I did stop the tamoxifen, but that was a bit ovr a year ago, but my vaginal health has never stopped being a problem since then. The incontinence and frequent UTI' really aggravate the crap out of me. I have only gotten 2 Mona Lisa Treatments, so I am planning to go get a third and see if it will improve some more. It got a bit better after the second treatment, but I still frequently get UTI symptoms after any sex, hell even when not having sex. The incontinence improved and so did the pain with sex, to some degree, but not enough to make me happy.

There are 2 forms of Estogen women use, Estradiol and Estriol. Estradiol is the stronger Estrogen, and the form that ebs and increases intermittently during a normal menstrual cycle. Estriol is the form of Estrogen that predominates during pregnancy, and is a less potent Estrogen, and has much decreased risks of increasing the thickness of the uterine lining (uterine dysplasia) Women can use either of these Vaginal Estrogen forms, even women who had ER/PR positive bc are still able to safely use them because it doesn't have a systemic effect. Rather the Vaginal Estrogens stay localized in the vaginal/uterine area. They help to reverse thinning of the vaginal lining, decreasing pain, irritation and possible tears with sex.

Estradiol comes in the form of a prescription Vaginal Ring Insert called an Estring (that is left in the Vagina for 90days), Estrace, vaginal cream, ( same usage as the Vagifem and Vagifem, a Estradiol Vaginal Suppository., (used 1 daily for 2 weeks, then twice per week going forward)

Estriol is also by prescription, but is usually a specially Compounded Prescription Vaginal Suppository, that is more often prescribed by a Naturopath or a MD interested in Natural Medicine.

Whether to use Estradiol vs Estriol depends on several factors. Estradiol is the stronger Estrogen, and will more rapidly improve the health of your vagina. However, it is also known to increase the thickness of the Uterine lining, without Progesterone to counterbalance Estrogens effects, thus possibly increasing the risks of Uterine cancer.. Artificial Progestins are known, in and of themselves to increase the risk of breast cancer, which is why they finally stopped HRT. Natural Progesterone does not have a harmful proliferative effect on breast tissue, as has been shown through some well designed French Studies. Natural Progesterone has been safely shown to counterbalance the Vaginal Estrogens without increasing breast OR Uterine cancer. ( see the French Studies)

That seems like a no brainer, why Would you use an Artificial Progestin ( like Medroxyprogesteron) as a substandard, and dangerous substitute for Bioidentical Progesterone??? Here is a quote that explains it all

Synthetic progestins were originally developed to overcome the short half-life of progesterone and its high production cost.

Basically FOLLOW THE MONEY.

SO I plan to use Vaginal Estrogens only with concurrent cycling of Bioidentical Progesterone, off for the first 5 days of the month, and on for the remaining 25 days of the month (to mimic the cycling that would naturally occur during menstruation)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1974841/

Progestins and progesterone in hormone replacement therapy and the risk of breast cancer

Carlo Campagnoli, Françoise Clavel-Chapelon, [...], and Franco Berrino

Additional article information

Abstract

Controlled studies and most observational studies published over the last 5 years suggest that the addition of synthetic progestins to estrogen in hormone replacement therapy (HRT), particularly in continuous-combined regimen, increases the breast cancer (BC) risk compared to estrogen alone. By contrast, a recent study suggests that the addition of natural progesterone in cyclic regimens does not affect BC risk. This finding is consistent with in vivo data suggesting that progesterone does not have a detrimental effect on breast tissue. The increased BC risk found with the addition of synthetic progestins to estrogen could be due to the regimen and/or the kind of progestin used. Continuous-combined regimen inhibits the sloughing of mammary epithelium that occurs after progesterone withdrawal in a cyclic regimen. More importantly, the progestins used (medroxyprogesterone acetate and 19-Nortestosterone-derivatives) are endowed with some non-progesterone-like effects, which can potentiate the proliferative action of estrogens. Particularly relevant seem to be the metabolic and hepatocellular effects (decreased insulin sensitivity, increased levels and activity of insulin-like growth factor-I, and decreased levels of SHBG), which contrast the opposite effects induced by oral estrogen.

Runner81, even if your onco says no, you can make an informed decision and go ahead anyway, and ask the GYN to prescibe it for you. You live with it, not the oncologist.

Here is one more option that sounds interesting.

Intravaginally applied oxytocin improves post-menopausal vaginal atrophy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566058/

So I was reading more about the Vaginal Oxytocin study. It was done by a Swedish company. They had unexpectedly insignificant results of another Phase 2 study of their Vaginal Oxytocin gel, (called Vagitocin), but were very durprised that the gel they developed to be their placebo was as effective, if not more so than the Oxytocin Vaginal Gel. So they plan to release a nonprescription, NonOxytocin gel product next year in Europe called VagiVital. So who knows, maybe this will be something helpful.

I am going back on Vagifem Estradiol Suppositories tonight. I had a third MonaLisa last week, and still feel like I need help getting vaginal comfort back to close to normal. I am tired of half crappy sex, where I just want intercourse to be over with It makes me so angry and sad. . I plan to go for a 4th MonaLisa in 5 weeks. It will cost me $900 for another treatment, as I finished the series of 3.

Hi cajunqueen15, up to 9 UTI's PER YEAR? This is supposed to be a viable "treatment"??? Have they friggin lost what's left of their minds? Men wouldn't put up with this much disfigurement, debasement and loss of every thing that constitutes a decent quality of life. I have horrible regrets that I listened to them into letting them torture me. I never, ever feel safe and have so many, many problems. I feel like I am discovering new problems all the time. Sometimes the UTI problem is so bad that my sleep is completely wreaked, having to get up to pee multiple times during the night. It helped when I went on Vagifem after the last Mona Lisa, but I need to have another treatment. That is NOT paid for in the slightest with the stinking insurance. It will cost $ 900.! ! !