You say your doctor has recommended Premarin vaginal cream (conjugated estrogens) as part of a treatment approach for a prolapsed uterus. You’re hesitant to use a cream with hormones. There are no risks in using a topical estrogen—none. And there are no substitutes, per se. We use localized estrogens in our breast cancer survivors and see no risks of using these products. There is no significant absorption into the blood stream delivering the estrogen anywhere else other than the local tissues it is applied to.
I’m not sure of the goal in using the topical hormone cream. It is certainly indicated if surgery is being considered, or if a pessary will be used to treat the prolapse. Localized hormone treatment alone will not reverse or treat the prolapse, although it may make the tissues healthier if they are now “external” or exposed.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.