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[Nain56]

Please advise.

I am 69 and had estrogen positive breast cancer in 2006 so can only use vaginal estrogen for gsm symptoms

In Aug 2024 I started Ovestin 2 x a,week for vaginal gsm symptoms. After 4 months I started getting very severe migraines. I stopped Ovestin and within a week Migraines stopped, but gsm symptoms returned.
After consulting a menopause clinic my gynae put me on half applicator of Gynest 2x a week in Dec 2024. Gsm symptoms started to improve but after 3/4 months in April 2025 Migraines returned.

I have a review next week but am concerned about the very painful migraines and returning gsm symptoms if I stop vaginal estrogen.
Wondering if prophylatic  medication for migraine will help if I restart vaginal estrogen.
My gsm symptoms consist of painful sex, burning urination, constant urination urge, dry vagina and frequent utis.

Any thoughts?

[bombsh3ll]

What about trying vaginal prasterone instead, or ospemiphene tablets?

Your medical team should be making you aware of all the available options.

[Nain56]

Thank you but these are not suitable because I have had estrogen positive breast cancer.

[Garnet161]

Have you tried Vagifem instead?
Perhaps it's the additives rather than the estrogen - a doctor would be able to write a script for a compounding pharmacy to make up an estriol cream without the preservatives.
Just a thought.

[Nain56]

Thank you. I will mention this to my gynae.
I had never thought about this.😊

[CLKD]

Who told you that U cannot use vaginal atrophy treatment?  Quality of Life?  I never hesitated when prescribed estriol ........... it's a small amount of active ingredient, it mayB the fillers or packaging causing the migraine .......... rather than the oestrogen.

Did U suffer headaches during your menstruating years and R U able to explain migraine?  It's something: along with nose bleeds  : that I dread happening 

[Nain56]

I am allowed to use vaginal estrogen but not systemic. Vaginsl estrogen was working but after 4 months it seem to trigger severe migraines with aura. When I stopped vsginal estrogen the migraines stopped. I suffered from severe migrain in my teens, 20s 30s an 40s 50s when then stopped ...I had breast cancer aged 50 and periods stopped with Tamoxifen treatment.

My gynae has tried two different estrogen creams..Ovestin and Gynest. Both worked but triggered migraines with aura after 3 to 4 months.

Seeing my gynae for review so will ask her what to try next. Will mention additives in creams.

I read about Ospemifene but not sure if I am allowed that. Vaginal estrogen was amazing but sadly the migraines were unbearable.

Thanks everyone for suggestions.

[CLKD]

MayB get an appt with a dedicated menopause specialist for advice and let us know how you get on.