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Vaginal Estrogen Cream Not Good for Guys

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Q. Is my husband at risk of absorbing estrogen during intercourse after I've used Estrace cream vaginally?

A. According to the North American Menopause Society, Estrace or other vaginal creams (Premarin) should not be used right before sex because the partner may absorb the estrogen hormone through his skin (Journal of Reproductive Medicine, Jan. 2008). Over time estrogen could have a feminizing effect on a man.

Most people do not realize that creams, lotions and other topical skin products can be absorbed through the skin and may produce unexpected complications. To give you an idea how this could happen we share "The Mortician's Mystery." This 50-year-old gentleman had developed some unusual symptoms gradually over several years: reduced libido, smaller testicles, breast growth. When tested, his testosterone levels were low. It turned out that the embalming fluid he was using (without gloves) contained estrogenic compounds that were being absorbed through his skin. They were disrupting his hormonal balance. This was published in The New England Journal of Medicine, April 14, 1988.

To read a bit more about this case you visit the Tulane University e.hormone website.

You might assume that this experience is rare, but there is a surprising number of health and beauty aids with fragrance that may have estrogenic activity not to mention the chemical carriers called phthalates. Here is an interesting question about a common ingredient in many cosmetics:

Q. Is it true that lavender oil can increase female hormones in men and boys? If so, shouldn't there be a warning on soaps, shampoos and shower gels? A lot of personal care products have lavender fragrance whether you notice it or not.

A. Lavender does not increase female hormone levels in the body. Nevertheless, this herbal oil may act like estrogen on its own.

The lavender link was brought to public attention in the New England Journal of Medicine (Feb. 1, 2007). Researchers reported that three boys developed enlarged breasts (gynecomastia) after using styling gel, shampoo, lotion, soap or salve containing lavender oil.

The investigators detected lavender oil's estrogenic action in test tube experiments and cautioned physicians that repeated use of such products might lead to hormonal disruption.

Other scientists questioned the conclusion that lavender oil poses a potential risk to children. But the original researchers pointed out that the breast enlargement disappeared when the products were discontinued.

Men aren't the only ones concerned about estrogen exposure from creams and lotions:

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). Other 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.

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7 Comments

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I had the same issue with repeated UTI's for several years--every 5 or 6 months. Finally, I was put on a very low dose of generic Bactrim daily by a urologist. That, plus use of baby wipes for personal hygiene plus careful attention to fluid intake (lots of water) has really turned the tide. I haven't had a UTI in over a year now. I don't have a problematic family history so I have used Premarin vaginal cream for a number of years (even before the repeated UTI's), 3x week for 4 weeks then 2 weeks off.

I also stay away from soy products and suspected estrogen responsive products when I recognize them, and I too, as they throw me into night sweats and can give me odd headaches. But, importantly, I had recurring UTI's for years, without any real help from the physicians I tried to work with. In desperation I started reading whatever I could find, and learned that all foods we ingest become part of the whole chemistry that stays balanced or gets out of balanced, as when a UtI is a symptom of something not being right.

The change I made that may be helping is in paying attention to my PH levels. I found whenever I had a UTI, I also had an extremely high Acid PH. I had found years before that some spices used in cooking some Asian foods, threw me right into a UTI, and more recently, that consuming a higher than average amount of processed grain foods, like lots of wheat bread and rolls causes dangerously high PH in me also. (I suspected a gluten problem, but have been expensively tested, test clear for the gluten - but still am grain sensitive) I rather expect that this is not true for everyone, but it definitely is for me.

I did an initial experiment, and have just continued it, in reducing acid producing foods and increasing alkalinizing foods to my diet (more veggies, some fruits, etc. information on a PH balanced diet is easily available. In addition to altering my diet, I take a cranberry extract supplement, OR drink cranberry/blueberry or pomegranate juice - daily, and take a probiotic every night and morning. This all seems to be working as I have not had a UTI in well over a year. I hope you can benefit from this information.

This is just a comment that was brought to mind by reading the lavender article. Years ago my young son was told to use teatree shampoo for his dry scalp by a hair stylist. I don't know if it's hormones that cause it but I read an article that stated teatree also enlarges breasts in males. We discontinued the teatree immediately.

I am concerned that your Doctor would get "very angry" when you asked questions about medication that could affect your future health. Any Doctor who is more concerned about his own ego than about your right to know how medicine could affect you, especially considering your family history, isn't worth your time in my opinion. Good for you for asking questions. It is your right and responsibility to do so.


When I turned 66 years old I started experiencing severe vaginal dryness & pain that made intercourse impossible, as well as frequent Barthalin cysts. Since my OB/GYN prescribed Premarin cream I have not had symptoms as long as I use the cream about every 3 days. I have tried numerous OTC creams without relief. What do you suggest one use in place of Premarin cream?

I have only had 3 UTI's in my 72yrs of living and every time it came on after eating ice
cream several days in a row. If I quit eating it at the first pain, I can avert it. Had
the discomfort last week and went for a "pee" test. Unfortunately they had to send it to
the lab. I couldn't wait 48hrs for results, was leaving town and Dr called in prescr.
for CIPRO. I couldn't believe it and refused and asked for Bactrim which I once used
with no side effects. 4 days later they left a message at home saying it was negative.
I took the blasted pills for nothing! Most docs do the urine test in the office. I'm
getting a new primary.

I think you do not understand what testing for a UTI entails. All offices will do a quick urine dipstrip test that INDICATES a likely UTI, but it cannot give any information about what specific organism is causing the infection. It just can't - it is a set of chemical test strips that can indicate the presence of bacterial waste (think bacteria pee and poop!) in your urine, and the presence of excessive white blood cells in your bladder (a good sign that you're fighting an UTI). A culture test is the only test now that can identify the best drug to fight your UTI, and that takes time (overnight to 36 hours depending on the infecting organism). You cannot do an "instant" culture of urine in any office... bacteria just take time to grow before a microbiologist can possibly identify the particular microbe causing your UTI.

You just want a doctor that sees your instant dipstrip result and takes a guess and prescribes something that he/she knows is LIKELY to kill off whatever infection you have. Your doctor picked Cipro because it can kill many different types of bacteria. You wanted Bactrim instead. Whatever. Just tell your doctor that before he/she writes the script next time. If you don't communicate, how can a doctor read your mind? You asked for a solution to your UTI and you got it.

If you wanted only a specific solution, say that you only want Cipro if the culture results indicate it is required. (Then you start on Bactrim and only switch to Cipro if the lab indicates it is the best drug to attack your particular infective bacteria!).

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