A warning has been issued by the US Food and Drug Administration about using a particular spray form of topical estradiol (Evamist) to control hot flushes. Women using it should avoid touching children and pets with treated areas of the skin as they have received eight reports of children ages 3 to 5 who showed breast enlargement and other signs of estrogen exposure after contact with women using the product.
Now this is not a large number but it definitely needs to be paid attention. Evamist is recommended to be sprayed onto the inside of the forearm so that transfer can occur if the child or pet is picked up and held against the area and they are suggesting that users of the product should wear long sleeves to cover the application site.
The symptoms that were seen of premature puberty in girls, including development of breast buds and breast mass, and enlarged mammary glands in boys, appeared several weeks to months after the adult patient began using Evamist. Some problems were resolved after the woman stopped using the product or took steps to prevent children’s exposure.
The concern about house pets was based on two reports where spayed female dogs developed signs of mammary or nipple enlargement, vulvar swelling, and liver failure in one case and vaginal prolapse and elevated estrogen levels in the other. The exposure occurred through licking of the owner’s arms or by the dog being held by the owner.
The FDA indicated that at present it is unknown whether unintended exposure can occur with other topical estrogen products and are working with Evamist’s manufacturer to identify factors that may heighten risks of accidental exposure, as well as ways to reduce or prevent such exposures.
If you are concerned, and are using a topical estrogen product, then please consult your doctor.