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Tamoxifen and vaginal estrogen use

Tamoxifen and vaginal estrogen use

Question

Dear OncoLink "Ask The Experts,"
Over the counter lubricants do not alleviate the atrophic vaginitis that I am experiencing with tamoxifen use. Will using estradiol(25mcg) twice weekly inserted vaginally nullify the efficacy of tamoxifen?  

Answer

Kevin Fox, MD, Assistant Director, Clinical Affairs and Associate Professor of Hematology/Oncology at the Abramson Cancer Center of the University of Pennsylvania, responds:

The effect of vaginal estrogen on the efficacy of tamoxifen is not known. However, you should realize that tamoxifen works quite well in women who are premenopausal and make normal amounts of physiological estrogen. Therefore, vaginal use should not interfere. We recommend vaginal estrogen when necessary in our patients.