Embarrassing. Vaginal cream

Hi Lostagain 

There are vaginal creams that don't contain oestrogen and these are perfectly safe with Letrozole and are recommended by doctors when you have had oestrogen positive breast cancer.  E.g. a couple Replens or Vagisan. 

Hope this helps you.

Kindest wishes,

I've found the best one is Activ Balance pessaries. I have to buy them as not available on NHS (I don't think) but I've found they're far better than anything I was prescribed.

Another thing to try is dilators as well. I must admit that I'm not very consistent with them but they do help with vaginal atrophy. I have found that chemo and medical menopause has caused everything to be far too tight and it is painful to have sex. I have a very understanding partner and we take it slowly. I'm hoping that things may improve more once I'm no longer on the medication.

Hi Lostagain

Thanks for your post and well done for getting through your treatment!

It's good to hear that you're thinking of life going forwards. I think we really don't speak enough about how treatment affects our sexual self and  lives.

The vaginal atrophy and dryness is a real chore!

I use a non-hormonal water based lubricant called Yes vaginal lubricant.(link below) It's consistency is very similar to our natural body fluids. I find it very helpful. I asked my GP to prescribe it, after finding out about it independently.

I also think we can feel anxious about sex during and post treatment and that can ause our bodies to tense, adding further tightness. I find that getting really relaxed and even breathing exercises help.

https://www.yesyesyes.org/?gad_source=1&gad_campaignid=21339658237&gbraid=0AAAAAD9-Mk_z2d-UB974ZLe9ZjUj-wLhQ&gclid=CjwKCAjw7fzDBhA7EiwAOqJkh7nTnasMVKZjD2FjmiBcJfMFp1UGWATUv_09pgnjDnZ7uHO89bKIaxoChIwQAvD_BwE

Wishing you well, Shaka 

Hello losagain,  Oh I do understand what you mean about vaginal dryness.  The absence of estrogen really puts our happy place in a dry desert.  Don’t be the least bit embarrassed about the issue as it is very common.  I had been on HRT for 17 years prior to my breast cancer so never had any issues with dryness. After I started the Anastrazole it became an issue and none of the doctors had really mentioned it in depth.  I did get a sample of reveree vaginal suppositories which is hyaluronic acid a good moisturizer.  I use it 3 x week and it was just ok but knew it didn’t solve my issue.  I did lots of research about vaginal estrogen when I had first started Anastrazole and the studies advised against it as was some risk of recurrence with the aromatase inhibitors but not with tamoxifen.  Well now the studies are not supporting this anymore for low dose vaginal estrogen.  I saw my medical oncologist in January 2025 and he said I could do low dose vaginal estrogen.  I got a referral to female urologist and got prescription for it.  She told me to throw away the applicator and apply a pea size of cream just inside opening of vagina 3 times a week.  My tissues are not as dry.  I still use Revaree too.  Reverse is not available outside the US

I also watch Dr Liz O’ Riotdan and also Dani Binnington on YouTube and some excellent videos.  Rachel Rubin,MD is wonderful and really knows about vaginal estrogen.  In the low doses we take nothing shows up on blood tests.  
We need quality of life too.  Here is a picture of the vaginal cream.

Hi,

Could you speak to a female member of staff at your GP surgery? Which is what I did when I went for a smear test. 

She prescribed Vagifem which is a pessary containing oestrogen - so I checked with the Breast Care nurse who said that was exactly what they would prescribe. 

I had oestrogen positive cancer and am on anastrozole. But, the pessaries are such a local treatment that they are happy to prescribe them.

And they make such a difference. I also use the Yes VM moisturiser which doesn't contain hormones on the outside bits, and which is very effective.

Good luck.