Q. I have a lengthy history of urinary tract infections (UTIs) that occur approximately every five months. I have seen a few urologists and had multiple tests, which have all come out normal.
Both my current urologist and my gynecologist are pressuring me to use Premarin vaginal cream to reduce UTIs. Due to the fact that my mother, her sister and my sister have all had breast cancer, I have refused. Last month at my annual exam my gynecologist insisted that the vaginal cream is not absorbed into the blood and will not promote breast cancer. When I mentioned the warnings I’ve seen in pamphlets and on the Internet, my doctor got very angry and said the warnings are for the “old HRT” and do not pertain to the vaginal cream.
I filled the prescription for Premarin cream but found in the literature insert that the top side effect listed is breast cancer. I am terribly confused and do not know which path is the correct one.
I have always been told with my family history to avoid all estrogen, even soy products, but I don’t want to be foolish by damaging my health with continual UTIs.
A. Over three decades ago there was evidence that vaginal estrogen cream (Premarin) could be absorbed rapidly and efficiently into the bloodstream (JAMA, Dec. 14, 1979). More recent studies have confirmed that estrogen in vaginal creams or tablets (Vagifem) is readily absorbed into the body (Annals of Oncology, April 2006; Menopause, Jan., 2009). There are concerns that vaginal exposure to estrogen might increase the risk of breast cancer in susceptible women.