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Vaginal Estrogen Could Be a Menopause Management Option for Women with Breast Cancer

Women going through natural menopause may decide to try hormone replacement therapy. This is not an option for many breast cancer patients or survivors. However, some may be able to use vaginal estrogen.

ACOG explains that unlike systemic hormone therapy, which can travel throughout the body, vaginal estrogen is a local therapy, applied only to the vagina with a cream, ring, or tablet. As such, little estrogen enters the body at a systemic level. Also, preparations of vaginal estrogen generally have lower doses of the hormone.

Still, ACOG recommends that women try non-hormonal therapies, like vaginal moisturizers or lubricants, first. If those aren’t effective, then vaginal estrogen can be considered under the guidance of a woman’s healthcare team. The lowest effective does should be used, and the course should only last until symptoms improve.

Studies have not found any increased risk of cancer recurrence in women who use vaginal estrogen to manage urogenital symptoms related to menopause, ACOG says. However, more research is needed before vaginal estrogen can be recommended for women who use aromatase inhibitors. Women taking tamoxifen might benefit from a short course of vaginal estrogen.

ACOG added that any woman considering vaginal estrogen should have complete information about the benefits and risks so that she can make an informed decision.


American Congress of Obstetricians and Gynecologists

“The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer”

(Committee Opinion Number 659. March 2016)

“How Menopause Can Happen With Breast Cancer Treatments”

(Last modified: February 17, 2017)

“Vaginal Estrogen”

(Last modified: January 27, 2015)

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