Bad vagina days

When you're out of estrogen, you're bound to have some vaginal discomfort. Breast cancer chemotherapy as well as the long-term use of estrogen inhibitors to prevent recurrence can plunge survivors into an endless string of bad vagina days. While oncologists have used low-dose local estrogen therapy such as Vagifem tablets or the Estring to counteract these BVDs, a recent study suggests this may not be a wise strategy.

London researchers studied six women taking aromotase inhibitors (Femara, Aromasin, or Arimidex) as adjuvant therapy for breast cancer. The women had virtually undetectable levels of estrogen before initiating therapy with Vagifem for four months. All the participants experienced a prompt and significant rise in their estrogen levels. While hormone levels dropped to baseline levels in two of the women, the remaining subjects had sustained elevations that were notably elevated in two.

The investigators concluded that "Using this vaginal form of estrogen which, we found, increases systemic estradiol levels, will counteract aromatase inhibitor treatment." The efficacy of aromatase inhibitors depends on near total suppression of estrogen causing concern among the researchers that long-term use of vaginal estrogen would increase the risk for recurrent cancer.