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E-String Use After Breast Cancer

E-String Use After Breast Cancer

Question

Dear OncoLink "Ask The Experts,"

I had a lumpectomy on Sept 7th and have ended 16 radiation treatments. Prior to my diagnosis, I had been taking Premarin 0.3 mg for approx 18 years. I stopped cold turkey when diagnosed. I have been having problems with vaginal dryness and would like to know what your opinion is of the E-string?

Answer

Nancy Zieber, RN, MSN, CRNP, Oncology/Hematology Nurse Practitioner, responds:

I usually ask my patients to try Astroglide (for use during intercourse) or Lubin (also for use during intercourse), in addition to using Replens on a regular basis, at least 3 x weekly (with or without intercourse, as it is absorbed, whereas the others are only lubricants). If this does not work after a month, then I go to E-string. Because E-string contains estrogen, one consideration is whether your breast cancer was estrogen receptor (ER) positive or negative, because theoretically, only ER positive tumors would be at risk of growing in response to estrogen in the body. Usually, to be safe, we say no to using estrogen products. However, quality of life is important as well, and there is minimal systemic absorption of E-string, so it may be safe.