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Estrogen and Smoking

From the Ask a Doctor - Hysterectomy Related Questions Articles List

Woman smokingI had my hysterectomy 2 years ago and I must confess I’m a smoker. Is it safe for me to use vaginal estrogen cream? My own GYN says its not to worry about as it doesn’t go through the blood stream but the prescription insert says I’m not to smoke while using it. What should I do?

Vaginal estrogen treatment is very safe for most women…even smokers. Of course you should give up smoking for so many reasons, but that is different health issue.
Topical estrogen is great for the treatment of vaginal atrophy (thinning of the vaginal walls), due to declining estrogen levels. The warnings that are included with a vaginal estrogen prescription are scary to read and the drug companies must list all the risks of estrogen even when not relevant for local versus systemic use.

Vaginal estrogen is not absorbed throughout the body at the levels needed to treat hot flashes and night flashes, and therefore the same risk factors for hormone replacement therapy do not apply to local vaginal therapy. Even though there is very low absorption, women who have a history of certain female cancers may not be candidates for vaginal estrogen and need to check with their cancer doctors.


Dr. Lori Warren received both her Bachelor's degree and Medical degree at the University of Kentucky, and completed her residency training at Tufts University, Boston, MA. She is board certified in Obstetrics and Gynecology.

She is a physician in the practice of Women First of Louisville. As a Minimally Invasive Gynecologic Surgeon, Dr. Warren has worked nationally and internationally to train other surgeons in laparoscopic techniques. She is an Assistant Clinical Professor at the University of Louisville, Dept. of Obstetrics and Gynecology. She is passionately devoted to reducing the large number of unnecessary abdominal “open” hysterectomies performed in the United States. Dr. Warren's goal is to inform women about their surgical options and help women gain access to the best and least invasive procedures.

She is the founder and director of Pass the Pearls, a non-profit organization dedicated to changing the world of women’s healthcare, spreading the word about state of the art surgical care for women and improving access to minimally invasive surgery.

09-02-2016 - 02:39 PM


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