Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Estrogen cream while breastfeeding

22 June, 2011
Question:

Hi, I had a baby about 8 months ago and have been breastfeeding ever since. I have a lot of pain during intercourse and went to my OB who said that I was very dry due to lack of estrogen and should expect to bleed during intercourse, but that the blood was not from my uterus (he is frum). He suggested lubricant and a medication called estrace but I dont want to take it since I am breastfeeding and it is a category X drug. We have been using lubricant but I see blood on the toilet paper afterwards, although not on my underwear. My son also doesn’t tolerate formula very well so I can’t stop breastfeeding. I just wanted to make sure that I am not a Niddah and if there is anything else you could recommend. Thanks.


Answer:

Mazal tov on the recent birth of your baby!

As long as you wait at least a few seconds (ideally, about 15 seconds) after urinating before wiping, you may disregard any stain you find on toilet paper and are not rendered niddah. You should also take care to wear colored underwear and use colored sheets, so if you do experience any staining on the underwear or sheets it may be disregarded.

Additionally, you should wait a few minutes after intercourse before getting up or cleaning yourself and try not look for any staining.

To help prevent the pain, you should certainly use the lubricants suggested. If that does not help, following your physician’s recommendation to use Estrace makes sense. The Estrace you are referring to is simply a topical estrogen cream. Even if some is absorbed into the system, small doses of estrogen are not a problem with breastfeeding, especially for an 8 month old. He is old enough to be eating foods as well as nursing, and thus if there is a reduction in supply (the only concern about estrogen during breastfeeding) the gap can be filled with food. Please note that Category X refers to dangers in pregnancy, not breastfeeding. The concerns at each time period are not the same.

Please feel free to get back to us with any further questions.

This response has been updated to reflect the rulings of our current Rabbinic Supervisor, Rav Kenneth Auman, regarding waiting before wiping.

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