Would you prescribe vaginal estrogen cream for vaginal dryness to a patient in her 40s with a history of stage IA granulosa cell tumor?   

Systemic serum absorption after use of low-dose vaginal estradiol inserts (such as 10 mcg estradiol tablet or 7.5 mcg/day estradiol ring) is very low. One study (Notelovitz et al., PMID 12039110) showed that baseline serum estradiol levels were 7-8 pg/ml in postmenopausal women. With the use of a 10...