Estrogen & Breast Cancer: The 3 Things You Need to Know

By Judy Couch, FNP-C
With over 2 million breast cancer survivors in the U.S., there has been enormous debate surrounding using hormone replacement therapy during and after breast cancer treatment. The debate focuses on estrogen-dependent breast cancer (also called estrogen receptor-positive cells, or ER-positive); these cells have receptors (proteins) that attach to estrogen and, if the estrogen levels are high, use it to grow and spread.
While many doctors had previously cautioned using estrogen following breast cancer, new research from the American Congress of Obstetricians and Gynecologists (ACOG) suggests otherwise.
Why would I use estrogen after breast cancer?
Women who are treated for estrogen-dependent breast cancer, as well as natural menopause in survivors, often experience female-specific issues that negatively impact their quality of life. These include:
- Vaginal atrophy (inflammation)
- Vaginal dryness
- Bleeding
- Bacterial infections
- Painful intercourse
- Vasomotor symptoms (hot flashes, night sweats)
It is estimated that up to 20% of all breast cancer patients stop or consider stopping therapy due to the severe detrimental effect on their quality of life (ACOG).
Is there an increased risk of using estrogen after breast cancer?
According to ACOG, “data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms.”
Additionally, there are actually long-term benefits to estrogen replacement for both survivors and those without a history of breast cancer. The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline by Dale Bredesen explains, among other things, that keeping estradiol levels optimal is important in preventing and reversing cognitive decline.
Is there a non-hormonal therapy?
There are non-hormonal therapies, including the O-Shot, diVa, and diVaTyte, but these may not always be enough for breast cancer survivors. The ACOG committee recommends using hormone-based therapy for these cases.
We believe in empowering women to own their health and happiness. If you are a breast cancer survivor or are experiencing the symptoms above, please give us a call at 513-791-9474 or fill out our online sexual medicine health history form to get started on your personalized journey. We are here to help you feel better, live better, and look better.