It is frequently used in that situation, but it is a decision to make with your oncology team rather than unilaterally. Systemic absorption is very low, and for women on aromatase inhibitors with severe symptoms the balance often favors using it. The conversation should involve whoever is managing your cancer follow-up.
Why it is different
Las Vegas treatment options: a local treatment, not a systemic one
Dose is where the confusion starts: micrograms and milligrams sound alike, so a Las Vegas patient often assumes a vaginal preparation carries the same considerations as a patch. Vaginal estrogen is dosed in micrograms where systemic therapy is dosed in milligrams. It acts on the tissue it touches: the vaginal wall, the vulva and the urethra, all of which are rich in estrogen receptors and all of which thin after menopause.
Because so little enters the bloodstream, the contraindications that apply to systemic therapy largely do not apply here. Many women who cannot take systemic estrogen can still use a vaginal preparation, including some with a history of breast cancer, after discussion with their oncology team.
It also treats symptoms systemic therapy often misses. A woman on a patch for hot flashes may still need a local preparation, because a systemic dose does not always reach that tissue adequately. There is more in treatment options, testosterone for women and breast cancer and hrt. A patch that controls hot flashes may still leave dryness untreated, and a Las Vegas review is the place to say so before concluding the treatment failed.
