Risks of Estradiol 0.01% cream for urinary incontinence?

ksusan · January 2018

This has been mentioned briefly on BCO, but in threads on vaginal dryness.

With the blessing of my MO, I received a prescription from my gynecologist, who is an oncology specialist, for Estradiol 0.01% vaginal cream to try to treat the delightful urinary stress incontinence rapidly brought on by Tamoxifen/menopause.

I read the insert today, and it's got pages of dire warnings about the risk of blood clots, endometrial cancer, breast cancer, and dementia, among other outcomes. It includes specific warnings for women with abnormal vaginal bleeding, obesity, and diabetes, all of which both these docs know I have. The reference given is for the Women's Health Initiative (WHI), but the insert seems to be discussing oral estrogen. However, one article I read on the NCBI website commented that "the large blood supply surrounding the vagina ... results in higher uterine levels of a vaginally applied drug compared to systemic administration."

What's *not* included in the insert is any statistical abstract of adverse effects, and I don't have a current PDR. Does anyone know how high the risks actually are for these outcomes? I'm already working very hard not to have blood clots, endometrial cancer, breast cancer, or dementia

coraleliz · January 2018

I was given estradiol cream while I was on Tamoxifen. I used 1/2 the amount prescribed & only every other day. My GYN didn't like the idea because I kept growing polyps. It was his suggestion to use it less frequently. My urologist & BS were of the belief that "beast cancer patients need to take care of their vaginas"

When I was researching this medication, I came across information that suggested all those warnings didn't belong on the "cream" version of this drug. There was a push to have these warnings removed because they were only pertinent to the oral estrogens. The belief was the warnings were scaring women away who could benefit from the cream version.

coraleliz · January 2018

Something you might want to try that I found helpful for stress incont when I was taking Tamoxifen was jump roping. The first couple of times, I had to wear a pad. I would jump rope 100 times in between my weight training sets. I mentioned to my urologist that this seemed to help me the most. She said "of course it does, do you realize how many muscles you need to tighten to jump rope". Well actually I didn't. Kegal exercises did nothing for me. Since completing my 5 years on Tamoxifen, my urinary symptoms have resolved.

ksusan · January 2018

Thanks. I can give that a try. Kegels seem helpful for some, but not all, situations.

Risks of Estradiol 0.01% cream for urinary incontinence?

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