E-string

AlaskaAngel · Posted: Sat Jan 22, 2005 2:57 pm Post subject: E-string

Does anyone know why this product is essentially unavailable ("back-ordered") currently around the US?
_________________
Dx Dec 2001 at age 50
Lumpectomy Jan 2002, 1.6 cm IDC plus some DCIS
Node neg
ER+, PR+, HER2+++
CAF x 6, 35 rads+boost
NED
Tamoxfen 1 3/4 yrs
In 2 clinical trials
bc for mom and 1 sis and 1 aunt and 1 granny
ovarian cancer for 1 aunt

Muttsmom · Posted: Sat Jan 22, 2005 4:01 pm Post subject: Re: E-string

I plead stupid, what is E-string?
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

Kristen · Experienced user Joined: 01 Nov 2004 Posts: 60

Ok...i give up...what is E-String...
Kristen

penelopez · Senior User Joined: 11 Oct 2004 Posts: 165

Here is some info:

What is estradiol?
? Estradiol (a form of estrogen) is a female sex hormone necessary for many processes in the body. Estradiol vaginal products release estrogen that is absorbed directly through the skin of the vaginal wall.
? Estradiol topical is used to treat certain symptoms of menopause such as dryness, burning, and itching of the vaginal area and urgency or irritation with urination.
? Estradiol may also be used for purposes other than those listed in this medication guide.

Who should not use estradiol?
? Do not use estradiol without first talking to your doctor if you have
· a circulation, bleeding, or blood-clotting disorder;
· undiagnosed, abnormal vaginal bleeding; or
· any type of breast, uterine, or hormone-dependent cancer.
? Using estradiol may be dangerous in some cases if you have any of the conditions listed above.
? Before using estradiol, tell your doctor if you have
· high blood pressure, angina, or heart disease;
· high levels of cholesterol or triglycerides in your blood;
· liver disease;
· kidney disease;
· asthma;
· epilepsy;
· migraines;
· diabetes;
· depression;
· gallbladder disease;
· uterine fibroids;
· had a hysterectomy (uterus removed);
· a narrow, short, or prolapsed vagina;
· vaginal irritation; or
· a vaginal infection.
? You may not be able to use estradiol, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
? Treatment with estradiol long-term may increase the risk of stroke. Because of this risk, you should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking estradiol long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
? Estradiol is in the FDA pregnancy category X. This means that estradiol will cause birth defects in an unborn baby. Do not use estradiol if you are pregnant or are planning a pregnancy.
? Estradiol may decrease milk flow and have other effects on milk composition. Do not use estradiol without first talking to your doctor if you are breast-feeding a baby.

Kristen · Experienced user Joined: 01 Nov 2004 Posts: 60

I wouldn't go near this stuff with a ten foot pole...
Has anybody's doctor let them go on this stuff?
Kristen

Muttsmom · Posted: Sun Jan 23, 2005 12:29 pm Post subject: Re: E-string

I agree Kristen. Not only would I not go near it with a 10 ft. pole, but with all the "can't use if" listed, I don't know anyone personally that hasn't suffered from depression or one of those listed. That stuff sounds scary to me.
Nancy
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

Minnlady13 · Posted: Sun Jan 23, 2005 12:35 pm Post subject: Re: E-string

I sure would put it at the top of my Never Take This list. Lauri
_________________
Diagnosed 4/11/1996
Lumpectomy, 6 mm tumor
Neg. nodes
ER/PR+
33 rads
Tamoxifen, 5 yrs.
NED

penelopez · Senior User Joined: 11 Oct 2004 Posts: 165

Here is some more info:

ESTRING®
Pharmacia & Upjohn
Estradiol
Estrogen

Action And Clinical Pharmacology: Estring is a slightly opaque ring with a whitish core containing a drug reservoir of 2 mg estradiol. Estradiol, silicone polymers and barium sulfate are combined to form the ring. When placed in the vagina, Estring releases estradiol, approximately 7.5 µg/24 hours, in a consistent stable manner over 90 days. Estring has the following dimensions: outer diameter 55 mm; cross-sectional diameter 9 mm; core diameter 2 mm. One Estring should be inserted into the upper third of the vaginal vault, to be worn continuously for 3 months.

At menopause the ovaries cease to secrete estradiol (E2), leading to symptoms of estrogen deficiency such as sweating, hot flushes and sleep disturbance. A couple of years after the actual menopause, increasing numbers of women also report symptoms of urogenital estrogen deficiency such as vaginal dryness, genital pruritus, dyspareunia, dysuria and urinary urgency. These latter symptoms respond well to vaginal estrogen replacement therapy.

~ I have heard ladies on some of the boards being prescibed this by their doctors. Their doctors said that very little is absorbed. However, some of the doctors said they advised against it.

Muttsmom · Posted: Sun Jan 23, 2005 2:01 pm Post subject: Re: E-string

This would be one of those times if my doc said it was o.k. to take, I'd pass. I'll keep my hot flashes and night sweats, saves on the heating bill..... Smile

_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

AlaskaAngel · Posted: Sun Jan 23, 2005 4:16 pm Post subject: E-string, estrgens, etc.

Hi Everybody,

Pro or con, nobody seems to have an answer to the question I asked, so I am still puzzled by the shortage.

I read the comments with a lot of interest because I am a bc survivor whose doctors are not opposed to my use of the E-string. My onc is very respected in his field nationally, and my internist is no slouch either.

The package insert does indeed contain the warning about breast cancer. Whether it is there to simply provide protection for the manufacturer in these times of litigation for even the slightest possibility that it could influence the course of cancer or not is unknown.

We are a group of women with many, many different characteristics that influence our risk level. I would bet my bippy that the same docs who are open to my use of the E-string would be opposed to the use of it by some women who are staged III or IV, for example.

Another aspect to this question is the degree of change in any particular woman's life as a result of her treatment for cancer. There are many women who are younger (and some who are older as well) than others and who do not experience the extreme, abrupt, permanent loss of libido, loss of lubrication, and loss of sexual identity to the degree that others do.

That is why I don't think it is best to treat this as a black and white issue. Each one of us suffers different aspects of cancer to different degrees that beg for compassion and understanding, rather than division among us.

All too often health care providers dismiss this as simply an issue of figuring out how to provide adequate lubrication for the mechanical process of coitus. Most of the health care providers that we have the most constant access and exposure to will defer this issue to the oncologist. That is appropriate IF the the oncologist is genuinely dealing with the patient's full range of problems that are a direct result of the therapy prescribed by the oncologist.

Unfortunately, much of the time once the issue has been deferred to the oncologist and the oncologist makes a professional recommendation one way or the other, none of the other health care providers deal with any of the variety of other aspects of this problem that are facing the patient. Those issues are there, they are not simply "in the patient's head", and they need to be discussed with a focus on looking for solutions.

For some women, a valid PART of that solution is the use of the E-string or other similar products.

Just as we are understanding of each woman's choice in which therapies to use in the first place (such as chemo or rads, or hormonal treatments, etc.), let's not paint a black picture of this option for women who are simply trying to find a way to deal with their particular situation. Just as there are bc survivors who can perform coitus adequately with fake lubrication alone, there are those who need more than that and are finding the act of love to be a form of great pain both physically and psychologically.

Best wishes,

AlaskaAngel
_________________
Dx Dec 2001 at age 50
Lumpectomy Jan 2002, 1.6 cm IDC plus some DCIS
Node neg
ER+, PR+, HER2+++
CAF x 6, 35 rads+boost
NED
Tamoxfen 1 3/4 yrs
In 2 clinical trials
bc for mom and 1 sis and 1 aunt and 1 granny
ovarian cancer for 1 aunt

Roxi1 · Posted: Sun Jan 23, 2005 5:09 pm Post subject: Re: E-string

Hi Alaska Angel

I think that vaginal dryness can be a 'big deal' too. With me, it became so bad, that I started itching, and then, because I scratched (oh yes, I couldn't stand it anymore), I burned when I urinated. I had tried the usual lubricants on the market, but none of them helped. I sure didn't want to go back on HRT (which is what I think gave me BC, but that's only MHO); so, my doctor ordered a vaginal estrogen cream (I think this is something similar to what you are talking about). The e-string has a more regulated low dose, and more consistency than the cream (for those who use the cream, they must not follow the instructions, but only put a little dab on their fingers about twice a week, otherwise, you do have a slight increase in your blood levels of estrogen
I don't know if you have ever heard of Replens. Replens is not an estrogen and causes your vagina to absorb water and be more supple. You can purchase it OTC. I was thinking about trying that, as it seems to be more effective than the lubricants.
Anyway, best of luck with whatever you choose.
Roxanne
_________________
Roxanne
Lumpectomy R. Breast 1/5/05, Post-Menopausal
1.2 cm invasive ductal CA
Histology Grade 2
Estrogen/Progesterone +
Her-2/neu Negative
Nodes negative, 2 Sentinel, 8 other nodes
RT 28+5, Tamoxifen (as osteoporosis)

leo · Site Admin Joined: 23 Sep 2004 Posts: 1574

Hello

Topical estrogen for vaginal drynness has been shown to be ok. The medication only acts locally.

regards,
Leo
_________________
Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.

penelopez · Senior User Joined: 11 Oct 2004 Posts: 165

I don't see anyone painting a black picture of this option. Nancy and Kristen didn't know what estring was so I gave them some information. Plain and simple. And then they stated their opinions. They certainly didn't tell anyone else what to do.

Most issues are not black and white regarding any kind of treatments and each women has to decide what she wants to do. Of course menopausal symptoms, vaginal dryness, urinary problems and painful sex are very important issues. No one would argue that.

Personally, I don't care whether someone wants to take "whatever" or not. It's completely up to them.

AlaskaAngel · Posted: Sun Jan 23, 2005 8:11 pm Post subject: Vaginal estrogen

You're right Penelopez, and thanks for pointing those things out. This is a good place for women to learn what legitimate choices they can consider when they are looking for answers that are often hard to find.

AlaskaAngel
_________________
Dx Dec 2001 at age 50
Lumpectomy Jan 2002, 1.6 cm IDC plus some DCIS
Node neg
ER+, PR+, HER2+++
CAF x 6, 35 rads+boost
NED
Tamoxfen 1 3/4 yrs
In 2 clinical trials
bc for mom and 1 sis and 1 aunt and 1 granny
ovarian cancer for 1 aunt

Kristen · Experienced user Joined: 01 Nov 2004 Posts: 60

Hi Alaska Angel,
I found this question posted on another site.
Here is the question and answer they posted.

Q. Please help me locate Estring. I?ve been using it for a couple of years to alleviate vaginal dryness.

A. The manufacturer of this low-dose vaginal estrogen delivery system has had Estring on backorder since July. A representative for Pharmacia & Upjohn reassured us it is not a production or safety problem, but rather a paperwork snafu with the FDA. He was hopeful that you would be able to fill your prescription sometime in December.

In the meantime you might want to try Sylk. This natural lubricant is made in New Zealand from an extract of kiwi fruit vine. It is available in the U.S. from 866-831-2920

I know nothing about the E-String or this suggested product, just happened to come across this info when I was searching for something else. Maybe this will help you some, but as you can see Decemeber has come and gone and this question was posted in November, so looks like it is still on Backorder!
Kristen

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