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Help for Sexual Issues

Posted 11/22/2016

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  From Medscape comes this encouraging report of a study at UCSF that suggested that the Estring is safe for women who have been diagnosed with an ER positive cancer. As many of you know, breast cancer treatment can catapult women into menopause. The sudden loss of estrogen, later compounded by years of anti-estrogen treatment with Tamoxifen or one of the AIs, can result in difficulties with intimacy.

  Specifically, the loss of estrogen often causes vaginal dryness and, perhaps, vaginal atrophy= pain with intercourse. It only takes a couple of painful experiences for a couple to acknowledge difficulties and concerns.     Very honestly, there isn't a lot of useful advice, but some women have found real relief with the use of topical vaginal estrogen--usually delivered by a device called an Estring. There has been ongoing controversy as to whether this is safe, whether it might risk upping a recurrence risk.

  This study seems to diminish many of those worries. Of course, this is still a conversation to be had with your oncologist. There are never absolutes and each of us must weigh our particular situation with our doctor's advice.

Vaginally Delivered Hormones Ease Urogenital
Symptoms From Aromatase Inhibitors

By Marilynn Larkin

NEW YORK (Reuters Health) - Both an estradiol-releasing vaginal ring and intravaginal testosterone (IVT) cream effectively treat vaginal atrophy and sexual dysfunction due to aromatase inhibitor treatment in women with early-stage breast cancer, researchers say.
Dr. Michelle Melisko of the University of California, San Francisco told Reuters Health in an interview, "The take-home message is that with careful supervision and monitoring of estradiol levels, a vaginally-delivered, hormonally-based intervention is a reasonable option for patients with hormone receptor-positive breast cancer and won't increase their risk of raising systemic estrogen levels."
As reported in JAMA Oncology, online November 10, Dr. Melisko and colleagues assessed the safety of a compounded intravaginal testosterone cream and a 2 mg estradiol vaginal ring, marketed by Pfizer as Estring, that releases 7.5 micrograms of estradiol every 24 hours for 90 days.
Participants were postmenopausal women with hormone receptor-positive stage I to III breast cancer with self-reported vaginal dryness, painful intercourse or decreased libido during treatment with an aromatase inhibitor. They were randomized to three months of the vaginal ring or IVT.

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