Time to Throw Out the Black Box – Vaginal estrogen is safe for most women

Time to Throw Out the Black Box – Vaginal estrogen is safe for most women
The secret is out of the box – half of all menopausal women suffer from vaginal dryness or painful sex.

And when women want to use a local estrogen on their private parts to ease the pain and heal the tissue, nothing could be safer. Yet the Federal Government requires the same “black box” warning on each purchase of local  estrogen as it does on much higher dosages taken orally or as patches on the skin – despite the fact there is no evidence to support it is harmful.

And we’re talking about a lot of women – 32 million. That’s the number of women in the United States with genitourinary syndrome of menopause – a condition in which the vaginal tissues become thinner, dryer and narrower from the lack of estrogen.

It’s hard to imagine that only 10 to 20 percent of women ever talk about it with their doctor and only 7 percent get treated. This may not be a topic you have ever discussed with anyone including your healthcare providers, but if you are one of the many women affected, it’s time to start the conversation and get help.

Why is this problem such a secret?

1) The symptoms may start 2-3 years after menopause and don’t seem related.
2) Many women don’t know there are effective treatments.
3) It’s embarrassing to discuss.
4) Many women believe vaginal estrogen will cause breast cancer.

At the most recent North American Menopause Society meeting, there was lots of discussion about the scope of this problem and the safety of vaginal estrogen. The fact is there is virtually no risk that vaginal estrogen leads to breast cancer. It is true that small amounts of vaginal estrogen get into the blood stream, but it’s miniscule.

As an example, according to psychologist Dr. Sheryl Kingsberg, if the vaginal estrogen pill Vagifem were taken for one year, the amount of estrogen that would get into the blood stream would be approximately the same amount as taking one birth control pill during that year. One year of treatment = one day of the pill.

Why do women think vaginal estrogen will cause breast cancer? Because the FDA requires that every estrogen-containing product have a “black box” warning that says estrogen can cause breast cancer, even though there is no evidence to that fact. And as I point out in my book, The Estrogen Window, if women take estrogen in their estrogen window, there is a reduction in breast cancer.

Painful sex and vaginal dryness doesn’t have to be something you grin and bear. There is an upcoming hearing in Congress on November 16, 2015 to try and get the “black box” warning removed and I hope we are successful in achieving that. In the meantime, if you are one of the 32 million women with painful sex or vaginal dryness, talk with your healthcare provider about vaginal estrogen or other treatments. Most importantly, know that it can effectively be treated. The secret is out of the box and the black box warning needs to be changed. Particularly since in March 2016 the American Congress of Obstetricians and Gynecologists published a practice bulletin #659 stating that if other methods of treatment weren’t working, local estrogen could be taken safely, even if a woman has had estrogen-receptor positive breast cancer in the past or is actively being treated for it.

For a free download of my latest eBook, visit www.FreeMenopauseEBook.com.

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