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Is Premarin Vaginal Cream Too Risky for Cancer Survivor?

Because Premarin Vaginal Cream supplies estrogen that is absorbed into the body, it may not be the best solution for vaginal dryness after cancer treatment.

Q. I was diagnosed with uterine and ovarian cancer last year. After a complete hysterectomy and months of chemo, I talked to my GYN/oncologist about vaginal dryness.

He prescribed Premarin cream. He said it’s very low dose estrogen and not absorbed into the bloodstream, unlike estrogen pills that are not advised for someone like me who has had a hormonal cancer. He told me that the risk of developing breast cancer from this cream is incredibly small. He’s the head of the department and a GYN/oncologist for over 25 years, so he should know.

A. The makers of Premarin Vaginal Cream specifically warn that it should not be used if you have had breast or uterine cancer, a stroke or heart attack, blood clots or liver problems.

During a current TV commercial for Premarin Vaginal Cream, the voice-over says,

“Estrogens may increase your chances of getting cancer of the uterus, strokes, blood clots or dementia.”

This suggests that estrogen is absorbed from the vagina, as studies demonstrated nearly four decades ago (JAMA, Dec. 14, 1979). More recent studies have shown that estrogen applied as a cream or tablet to the vagina is efficiently absorbed into the bloodstream. You can read more about them in this entry.

Most worrisome of all, a recent study in the journal The Lancet suggests that hormone replacement therapy increases the risk for ovarian cancer (Lancet, online Feb. 12, 2015). Analysis of 52 epidemiological studies around the world yielded a significantly increased risk for ovarian cancer among postmenopausal women using hormones or who had used them within the past five years. Since you have already been treated for this hard-to-treat cancer, you do not want to do anything that might lead to a recurrence.

Other Ways to Combat Dryness

After all your body has gone through in your cancer treatments, it is little wonder you are suffering from vaginal dryness. You will find other ideas about easing this debilitating problem in our Guide to Menopause. Many women find that lubricants such as Astroglide, Replens or Sylk can be great products for the bedroom.

Readers report that table-quality oil, especially olive oil or coconut oil, can be applied regularly as well as during sexual relations to ease the symptoms of dryness. KS wrote:

“What finally worked for me was cocoa butter. I put it on after a shower and keep a small jar close by to re-apply as needed and haven’t had a bit of trouble with dryness again.”

Janice is a cancer survivor too:

“I am almost 60, have been post menopausal for almost 6 years and sex has been nil for the last 2 and a half years. It was just too painful. Husband has been so understanding.

I’m also estrogen/progesterone positive breast cancer survivor. I will not knowingly take anything that contains either of those hormones. I went to see a new gyno last week (my former gyno retired), because of some vaginal soreness. She suggested olive oil. I’m more excited about coconut oil though. I already take 400 iu vitamin E every day orally. I’m going to give the coconut oil a try.”

Another reader has already tried coconut oil:

“I am 51 and a seven-year breast cancer survivor. I went through chemo and radiation, took tamoxifen until my hysterectomy 2 yrs ago. Since chemo I have had severe vaginal dryness. Sex was painful with burning and irritation for days afterwards.

“About a month ago I came across this website. I started using vitamin E and noticed a difference immediately. A couple weeks ago I switched to Organic Coconut Oil from Trader Joes in the morning and night. It’s wonderful. No more dryness!

“Intercourse is pleasurable again (coconut oil is not sticky and smells great). There is no swelling, burning or irritation afterwards. Reading all of the comments on your website has been a life saver.”

Other readers have found that the gel in an aloe vera leaf can be a helpful lubricant. We hope that one of these remedies will help you.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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