Fibroid has grown - estriol use the cause?

[EllenRipley]

Hello again.
Not my first time on the meno thread! I've asked about estriol cream before - was put on it for peri bladder symptoms and it's helped enormously. Have been told it shouldn't affect my one persistent fibroid (had it for 7ish years), though there's some guidelines that contraindicates estriol cream use if you have fibroids.

I'm currently getting an ultrasound every three months to keep an eye on an ovarian cyst. The last scan in June measured an approx 1.5 cm growth in the fibroid and today's scan showed it has grown at least another centimetre (so now measuring just over 5cm). My periods are very irregular (had one doozy in August which was the first in 6 months) so I am assuming that I'm at the low estrogen peri stage (estrogen known to feed fibroid growth). Am currently having a 'phantom' period; very crampy but no bleeding so it's possible I'm back to another six months period free.

The only thing I can think of that's caused the fibroid's sudden growth is the estriol cream. Any one have any thoughts or experience of this? I know there's a minuscule dose of estrogen in the cream but it's obviously thought to have an effect or why would it be mentioned in the usage guidelines? Thanks for any insight - I'm going to be gutted if I have to stop the cream but I don't want to end up with a massive fibroid!
Plan to discuss with GP.

The simple answer is no, it can't and won't be the Ovestin and Vagifem.
The dose of the cream is minute- if you use as directed- twice a week- for 1 year, that is the equivalent of 1mg estrogen tablet (orally).

One dose is a 1000th of a gram of estrogen. So twice that for 52 weeks = 1gm approx.

Your fibroid is growing due to your own estrogen which can surge in peri as your body tries hard to get the last eggs out!

If estriol stimulated the womb lining, all women using it would be required to have scans to stop it overgrowing (in time) and they don't . NICE says this is not necessary.
It's your own hormones most probably.

I assume when you say it's referred to in the usage guidelines that you mean the huge leaflet that is in the carton?

These leaflets are generic for any kind of HRT- you'd find the same leaflet (other than the actual product name) in all HRT whether vaginal cream, pills, gels or patches. They list the same risks for all but they do not apply to topical creams.

Sorry to keep coming back- where are the guidelines saying it's contraindicated with fibroids? That's not so. I use full HRT and Ovestin and have for 11 years under a consultant. I have a small fibroid- it's not grown at all (well, maybe 0.5cm in 11 years) and never even been mentioned .

Hi Queen, thanks so much for response.

I've read it on the leaflet as you say! and online ('official' stuff rather than anecdotal if you see what i mean, but they actually might have just been variations on the leaflet info rather than 'guidelines') - all said 'not recommended for women with fibroids'. I also read a study that had measured a serum oestrogen increase with estriol cream users? I don't know how relevant that is. But i do think you're right about about generic warnings for HRT, i did just read a study about marked fibroid growth over two years with full HRT users but obvs with your experience that's not necessarily always the case.

I'm just really surprised (and worried) I've had a 2cm growth in the last six months when I've had about one period in that time! I was def 'oestrogen dominant' from my early forties until about 18 months ago, very heavy periods and of course the fibroid so im just assuming since i now have other low oestrogen symptoms that there wouldn't be enough in my system to enlarge the fibroid (but maybe it doesn't work like that!) Im currently in the midst of what seems a horrible period - all the symptoms but no bleeding! Urrgh.
It does make sense that my body is having last gasp :o( Im due to see gynaecologist consultant in December - he's the kind that is suggesting i 'have it all taken out' and i don't think something so radical is necessary but now im wondering if he's going to push for it with the fibroid growth.
Thanks for reassuring me about the ovestin, I shall continue to use... x

There is all sorts on the web about 'not to use with/when' for lots of drugs,but it's not a replacement for a consultant gynae who specialises in meno (mine.)

Serum levels- there is some evidence of higher estrogen levels in the blood but this is usually only during the first two weeks of use. That's when the vaginal tissues are thin so absorption may take place .

After that time, the vaginal cells are thicker and less permeable.

A 5cm fibroid is not large- some women's are as big as grapefruits! But it depends of course on the overall surface measurement.

There are other treatments for fibroids such as removing it alone or a ablation - no need for a hysterect. unless you are in dire straits. You could have a Mirena which would control the bleeding and any effects of Ovestin.

Thanks @QueenoftheNights - all makes good sense.

How I wish I had a gynae with that specialism - between the gynae, urologist and GP that I've been seeing in the last couple of years, none have been willing or able to discuss my issues in the context of the menopause. I actually had to do my own research and go and ask for Ovestin. Unless last month's period marks the start of regular heavy bleeding again I'm hoping I can avoid intervention but I might also have to see if I can get a different gynae if the fibroid becomes a major issue and I have to consider options. Hopefully the size will just ebb and flow along with the hormones then shrivels when I'm past this bit!