By the way, doctor: Is vaginal estrogen safe for breast cancer survivors?
Q. I'm 78. I had breast cancer nine years ago and have been taking Arimidex for six years. I have pain and some bleeding after intercourse, despite using Astroglide. My gynecologist prescribed vaginal estrogen cream. Is that safe for me?
A. The likeliest cause of your symptoms is vaginal atrophy, a common condition in postmenopausal women. Symptoms include vaginal dryness, irritation, and burning. Pain and light bleeding with intercourse are common. There may also be urinary symptoms.
Vaginal atrophy is a consequence of both aging and low estrogen levels. Estrogen helps maintain blood flow to the vagina and helps keep tissues plump, elastic, and moist. As estrogen wanes, tissues become thinner and more vulnerable to infection and trauma with intercourse. Vaginal atrophy is most often due to menopause, but it can result from anything that lowers estrogen levels, including the use of aromatase inhibitors (AIs) such as Arimidex. AIs block estrogen production and are helpful in treating women with estrogen-sensitive breast cancer.