Latest news with #hormonetherapy
Daily Mail
2 days ago
- Health
- Daily Mail
Cancer treatment saved my life but left me unable to have sex - but a radical new treatment gave me my va-va-voom back
Like many women, when Anna Sullivan was diagnosed with breast cancer at just 37-years-old, her primary concern was surviving the treatment that would hopefully kill the disease and stop her cancer from spreading. But her second thought, which she was too ashamed to voice at the time, was: 'What will happen to my body?' 'After I was diagnosed back in 2017 my doctor told me that my treatment plan would catapult me into menopause,' she explained. 'The hardest thing about it was that I was unprepared. It was something that I thought was at least still a few years away. 'None of my friends had gone through it and my mum passed away the year before so I had no one. 'I was completely alone.' Thankfully, after a mastectomy and starting hormone therapy—which works by reducing the amount of oestrogen in the body and inhibits its cancer-growing effect—Ms Sullivan was given the all clear. The treatment ultimately saved her life—but, after months of gruelling side-effects, she can't help but think there must be a better option for women who have survived cancer. 'I was still under the care of my oncologist for my hormone therapy and it took me a while to figure out what was happening to my body and muster up the courage to talk about the symptoms,' she explained. 'At no point did a doctor mention the vaginal symptoms I might experience as a result of medically induced menopause. 'That's something I figured out on my own—when I tried to have sex with my husband.' The mental health councilor was suffering from a condition known as genitourinary syndrome of menopause (GSM). GSM is commonly experienced by breast cancer survivors on hormone therapy, causing vaginal dryness, pain during sex and can massively impact a patient's quality of life. 'It hurts all the time,' she recalls telling her oncologist. 'Especially during sex.' 'But my pain wasn't taken seriously. I was just told "if you don't use it, you'll lose it". 'I just had to get on with it.' Whilst dyspareunia is not uncommon during the menopause, as vaginal dryness can make penetrative sex more painful, there are a number of oestrogen-based products that can be used to help promote lubrication. But, given her cancer diagnosis and a lack of extensive research on the subject, Ms Reiser did not feel comfortable using an oestrogen based cream, for fears of increasing the risk of her cancer returning. 'Ultimately, my doctor's response just created more shame around symptoms I already felt uncomfortable discussing, playing into the culture of violence surrounding the menopause. 'When you are vulnerable and try to open up about what you're going through and then you're immediately shut down, you internalise that shame and it becomes something you don't talk about,' she added. Thankfully, Ms Sullivan eventually felt comfortable speaking about her symptoms with her GP who was able to recommend an alternative: PRP vaginal rejuvenation therapy. Recalling the conversation she said: 'She was the one who really educated me on the menopause and how it would affect everything from my energy levels to my mood, bone health, sleep and sex drive.' After trying what felt like every treatment available to her to alleviate her pain and get her sex life back on track, including laser treatment, Ms Sullivan booked in for PRP therapy. The treatment, which stands for platelet-rich plasma injections, works by using a woman's own blood component to promote healing and tissue regeneration in the vagina. A clinician will take a patient's blood before processing it in a centrifuge to concentrate the platelets—which are small cell fragments in the blood that form blood clots and promote healing. The concentrated plasma is then injected into specific areas of the vagina to simulate cell regeneration and support tissue growth. The treatment is said to provide a range of benefits from enhanced sexual function, through increasing sensitivity and improve lubrication, to pain relief and vaginal rejuvination. Whilst Ms Sullivan did not experience lasting pain relief after the treatment when it came to sex, she said it helped improve sensation and lubrication and opened the door for more open and honest conversation about cancer, sex and the menopause. She now uses a carefully-curated combination of treatments including pelvic floor therapy and low-dose oestrogen creams, after reading compelling new research, to treat her symptoms, allowing her to live an almost normal life. She said: 'I used to be really scared of using oestrogen creams, even though the pain was unbearable and ruining my sex life, because it was thought for a long time that oestrogen could increase the chance of breast cancer returning. 'I know now that this simply is not true. But the culture of fear around using hormone therapy started so long ago it's going to take a long time for that fear to subside.' She now wants to help reduce the stigma and shame surrounding the menopause, especially for women who have been left with no other choice but to face it early because of cancer. Her plea comes as millions of women could soon benefit from a new all-natural intimate cream being hailed as a female version of Viagra. Makers of the plant-based formula—called Myregyna—insist it can restore vulval health and 'bring back the joy of sex' for women battling the menopause, all without the use of hormones. Inventor Dr Iona Weir claims trials have shown the cream improves sexual response and function in women dealing with the effects of menopause. It's applied to the intimate area nightly and taken alongside a daily supplement, with results expected in as little as a month. The cream is designed to reverse the symptoms of GSM including vaginal dryness, incontinence, discomfort and pain during sex—all of which can severely impact quality of life. Currently around 90 per cent of women with cancer encounter seuxl health problems which can lead to long-term distress affecting personal and social well-being. Around half of post-menopausal women will experience vaginal dryness—most of whom don't seek treatment for their symptoms which typically include vaginal dryness, irritation and pain during intercourse.
Daily Mail
01-08-2025
- Health
- Daily Mail
Girl, 3, suffers dangerous reaction after being exposed to trans dad's hormone drugs
A toddler grew breasts and began experiencing signs of early puberty after she was accidentally exposed to her transgender father's hormone therapy. The unnamed child, 3, was brought to doctors in Denmark after showing signs of extremely early puberty that had persisted for six months, including enlarged breasts and nipples and premature vaginal discharge. Her father told physicians the pair had frequent skin-to-skin contact, a key part of bonding. The parent, however, was also undergoing estrogen therapy as part of a gender transition from man to woman. The father used estrogen cream across their body, including chest, abdomen, shoulders and thighs daily. Doctors warned that the girl had been absorbing the estrogen, a female sex hormone, from the skin contact, triggering premature puberty. This set off a cascade of potentially dangerous side effects. Premature puberty in females, before the ages of eight years, can lead to a higher risk of certain cancers, including breast and endometrial cancers, mental health problems, behavioral issues, eating disorders and substance abuse. The father had used a spray containing 6.12mg of estradiol, the most potent form of estrogen, on both forearms daily. But seven months before the child was taken to the doctor, the father had switched to using a 3.75mg estradiol gel. Along with enlarged breasts and nipples as a result of the exposure, an ultrasound revealed her uterus and endometrium, or lining of the uterus, had increased to a size seen in older females. Her bone age was estimated to be 7 years old, while she was 3ft 6in tall and weighed 43lbs, the doctors reported. The average three-year-old in the US is between 2ft 10in and 3ft 4in tall and weighs around 26 to 38lbs. To treat the case, doctors asked the father to switch from rubbing in a gel to using a patch on the skin to receive estrogen. They reported that after the change was made the girl experienced a regression of breast development, and a normalization of growth speed and pelvic size. In the study, the researchers from Aalborg University Hospital said: 'Transgender persons should be thoroughly informed of the risk of transmission of transdermal hormones and be advised to wash hands, use gloves and avoid skin contact shortly after hormone application. 'Patients with children must be warned of the risk and Gender Clinics should consider the possibility of prescribing alternative routes of administration such as tablets or patches in high-risk patients.' About 1.5million Americans identify as transgender, although it is not clear how many of these are parents or use estrogen gel. Women may also use estrogen gel to combat symptoms of the menopause, although this tends to be at lower doses. In a similar case revealed in Sweden last month, a 10-month-old baby girl grew a 'micropenis' after she was exposed to her father's testosterone. Her father had been using the testosterone to boost levels of the hormone, and rubbing it into his body using a gel. He was also practicing skin-to-skin contact with his baby, leading the testosterone to be passed to the infant. Revealing the case from 2023 in a report in a journal, the team warned parents should be 'thoroughly informed' of the risks of transferring hormones to their children. They advised washing hands after the application of hormones, wearing gloves, and avoiding close contact immediately after use. In high risk cases, they added, clinics providing care for transgender patients should consider alternative treatments, such as tablets or patches.
Washington Post
31-07-2025
- Health
- Washington Post
Answering your questions about underused menopause therapies
You're reading The Checkup With Dr. Wen, a newsletter on how to navigate medical and public health challenges. Click here to get the full newsletter in your inbox, including answers to reader questions and a summary of new scientific research. I heard from many readers with questions about my column this week, which discussed underutilized hormone therapies for menopause, especially low-dose vaginal formulations that can treat a common condition, genitourinary syndrome of menopause (GSM). This newsletter is focused on answering them. A number of women shared that they didn't know GSM existed; they just assumed symptoms like vaginal dryness and pain and bleeding during sex were an expected part of aging. Some experienced significant complications themselves. Mary from Wisconsin, for instance, wrote that she suffered recurrent bladder infections for years before a menopause specialist diagnosed her with GSM. The most common question I received was when it was too late to start treatment. As Sarah from Virginia wrote, 'I read your article and then looked up GSM on the internet. I have all the symptoms. But I'm old — 68. I hit menopause when I was in my 40s. If I can't use hormone therapy, what options do I have?' Sarah's question highlights why it is so crucial to separate systemic therapy, intended to increase hormone levels throughout the body, and low-dose vaginal therapy, which introduces only minimal estrogen into the bloodstream. The window to begin systemic therapy is typically within 10 years of the start of menopause (defined as a woman experiencing 12 months without menstrual periods) or before age 60. But no such time limit exists for low-dose vaginal estrogen. Physician and Harvard professor JoAnn E. Manson told me that women no longer eligible for systemic therapy may still experience significant relief with low-dose vaginal estrogen. She also emphasized that though hot flashes, night sweats and other symptoms treated by systemic therapies usually subside over time, GSM is a progressive condition that worsens without treatment. Several readers also asked how long they would need to use low-dose vaginal estrogen. University of Virginia OB/GYN JoAnn Pinkerton explained that most women require ongoing treatment. She tells her patients new therapeutic options may emerge in the future, but for now, 'if you stop therapy, you are going to see a reversal of the benefits, and you may very well go back to having the same symptoms.' One aspect that could change over time is the method of application. She advises patients to begin by using estrogen intravaginally. 'If women are older, and they are no longer interested in having vaginal sexual activity, I may transition to what's called topical estrogen, where we just put it around the vaginal opening, push a little bit in, and we still seem to get that benefit [of reduced infections], and it's a little bit easier for women to use,' she said. Pinkerton also addressed a question from Ellen from Vermont, about whether cancer survivors like her can use these treatments. In Pinkerton's experience, women who have had breast cancer are frightened to use anything containing estrogen. Yet there isn't evidence linking low-dose vaginal estrogen therapy and breast cancer. A meta-analysis published in the American Journal of Obstetrics & Gynecology in March found no increase in breast cancer recurrence or mortality among women with a history of breast cancer who used vaginal estrogen. Instead of deterring all cancer survivors from hormone treatments, she thinks a better approach is to for patients to work with gynecologists and oncologists to tailor the treatment approach. Right after cancer treatment, Pinkerton said, 'we might try vaginal moisturizers and lubricants. … But at some point, if they are having progressive symptoms, [low-dose vaginal estrogen] can be considered.' 'It seems there is a total 180-degree change in our thinking around hormone therapy,' wrote Jennifer from Maine. 'Twenty years ago, menopausal women were told to stop taking estrogen. Now, has the pendulum swung so much that women are pushed to take hormones, even if we don't have symptoms?' I think we are in the midst of a long-overdue reckoning. The misinterpreted 2002 Women's Health Initiative study unnecessarily dissuaded many women from using hormone therapy who could have potentially benefited from it. That said, it's imperative for scientific evidence to guide who should — and shouldn't — use it. Importantly, neither low-dose vaginal estrogen nor systemic hormone therapy are recommended for women without menopause symptoms. Multiple studies link systemic hormone therapy to fewer heart attacks, prevention of bone loss and lower mortality, but, as Manson explained, 'the evidence has been inconsistent.' Pinkerton tells her patients that systemic hormone therapy can relieve hot flashes, improve sleep and stabilize mood, with possible added benefits for cardiovascular, bone and brain health. But using it solely for disease prevention is another matter entirely, and the bar for evidence must be set much higher. Correcting outdated information does not mean recommending hormone therapy to every woman. Rather, women must receive accurate information and be able to access treatments so they can make informed choices throughout their life transitions. Have you been diagnosed with GSM and wish to share your story? I'd love to hear from you and to feature your comments and questions in a future edition of The Checkup.
Washington Post
29-07-2025
- Health
- Washington Post
The FDA should stop scaring women about this menopause treatment
For years, the Food and Drug Administration has been warning women about hormone therapies to treat menopause symptoms. The agency requires all estrogen-containing products to display a black box safety label — the most severe packaging requirement — claiming that they increase the risk of breast cancer, heart attacks and dementia.
CNN
24-07-2025
- Health
- CNN
Black box warning on menopause hormone therapies should be removed, experts say
All menopause treatments containing the hormone estrogen are mandated by the US Food and Drug Administration to carry a black box warning on the label, stating that the treatments could increase the risk of strokes, blood clots, dementia and breast cancer. Now, that advisory may be going away. Last week, a panel of experts convened by the FDA urged the federal agency to remove the cautionary language on at least some forms of hormone therapy. I wanted to understand more about why these warnings were first added and the arguments for and against removing them now. What are hormone therapies used for, and what are the different forms of treatment? What is the history behind adding black box warnings, and why are some experts pushing to remove them? What should women know about managing menopause symptoms? I turned to CNN wellness expert Dr. Leana Wen to answer these questions. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore's health commissioner. CNN: When does menopause occur, and what kinds of symptoms do women experience during menopause? Dr. Leana Wen: Menopause is the stage in a woman's life when her menstrual periods permanently stop. It marks the end of fertility and is accompanied by a decline in reproductive hormones such as estrogen and progesterone. In the US, most women begin the menopause transition between ages 45 and 55, and the average age is 52. The definition of menopause is a full year without having a period. Except in situations where menopause is induced by surgery (for example, removal of ovaries) or specific medical conditions, this period is generally preceded by a stage called perimenopause, when women may have irregular periods and start experiencing menopause symptoms. Symptoms associated with menopause can include hot flashes and night sweats. Hot flashes are sudden sensations of heat, skin flushing and sweating that can significantly disrupt daily activities. About one-third of women have more than 10 hot flashes per day. When they occur at night, they can disrupt sleep and increase fatigue and irritability during the day. Menopausal declines in estrogen also may cause vaginal dryness, decreased libido and discomfort during intercourse. Some women experience other symptoms such as mood changes, anxiety, difficulty concentrating, dry skin and weight gain. Moreover, while this is not a symptom of menopause per se, the risk of developing chronic conditions such as cardiovascular disease and osteoporosis increases significantly after menopause. This rise in risk is thought to be linked to the decline in estrogen levels, as estrogen has a protective effect on maintaining healthy blood vessels and supporting bone density. CNN: What are hormone therapies used for? What are the different forms of treatment? Wen: Hormone therapies are prescription drugs that are used to treat menopause symptoms. They replace the hormones that decline during menopause. It's important to differentiate between two types of hormone therapy. The first is systemic therapy in which hormones are given in a way that is absorbed into the bloodstream. That could be through taking pills or using patches, sprays or gels. Systemic therapy is used to treat symptoms that affect the entire body, such as flashes and night sweats. The second type is low-dose vaginal estrogen therapy. This is a cream or suppository administered into the vagina to treat vaginal dryness and reduce tissue thinning. Unlike systemic therapy, this type of therapy works locally; its purpose is not to raise hormone levels throughout the body. CNN: What is the history behind adding black box warnings, and why are some experts pushing to remove them? Wen: For decades, hormone therapy was considered the standard of care for menopause-related symptoms. Then, in the early 2000s, a landmark study called the Women's Health Initiative was published that suggested hormone therapy increased the risk of breast cancer, heart disease and stroke. It concluded that the benefits of this therapy did not outweigh these risks, leading to the FDA adding the black box warning in 2003. Many researchers have since examined the methodological problems of the study. One significant issue was that the average age of participants was 63. The women studied were mostly postmenopausal, so the question answered was regarding the risks and benefits to postmenopausal women, not menopausal women. Last year, scientists — including some of the original researchers of the Women's Health Initiative — published an updated analysis in the journal JAMA. They concluded that, in fact, hormone treatment with a combination of estrogen and progesterone is safe and effective for treating hot flashes and other systemic symptoms if started before age 60 or within 10 years of starting menopause and if the woman does not have specific contraindications — for instance, an estrogen-sensitive breast cancer. This updated analysis is one reason cited by many advocates to remove the warning. Another major reason is that the black box warning is currently on all types of hormone treatments, including vaginal therapies that deliver far lower doses and do not have the systemic effect of, say, an estrogen-containing pill. Advocates argue that putting all forms of hormone therapy under the same warning misrepresents risk and makes it harder for women to receive relief from troublesome symptoms. Women are still able to access the therapies despite the warning, but some may be more hesitant to use them after seeing the warnings. CNN: What are other arguments for and against this change? Wen: In his opening argument, FDA Commissioner Dr. Marty Makary remarked that systemic hormone therapy, when started within 10 years of the onset of menopause, can actually reduce cardiovascular disease. This finding is suggested by some recent studies, which also show a benefit for bone health. Not everyone agrees that hormone therapy should be taken for preventive purposes. There is also some controversy about process; specifically, the panelists who spoke at last week's FDA meeting were all selected by Makary and all favored hormone therapy. Some have said they would appreciate more balance by hearing from experts who have more nuanced views. In addition, there was no presentation by internal FDA scientists, who, in the past, have given their own analysis during these types of meetings. CNN: While the FDA is considering changing the warning label, what is your advice for women about managing menopause symptoms? Wen: The most important thing is that women who are experiencing significant symptoms during menopause don't need to suffer in silence. Effective treatments exist. Women should speak with their physicians about lifestyle measures that can help as well as hormonal and nonhormonal prescription therapies. They should also speak with their providers about preventive care to improve heart health and prevent bone loss. Those who want additional resources should look to the Menopause Society, which also has a searchable database of clinicians who are certified menopause practitioners and trained to guide women through this transition.
