Ever since the data from the Women’s Health Initiative demonstrated the risks of taking the synthetic hormones PremPro and Premarin, the use of topical hormones, especially compounded bio-identical hormone creams popularized by people like Suzanne Somers, have surged. Because topical hormones (applied to the skin) bypass the “first pass effect” through the liver, they are believed to be safer, with fewer risks. So patches like the Vivelle Dot, sprays like Eva-Mist, and estrogen creams and gels like those made at compounding pharmacies have become all the rage these days.

Even hormonal birth control may soon be available as a topical gel. A new study evaluated the use of a topical birth control gel in 18 women in a clinical trial, with good results. According to the study, these women experienced fewer side effects than those reported by women who took birth control pills.  Although I don’t particularly trust so small a study which only proved pregnancy prevention efficacy over a seven month period, and although I’m not convinced that this study really demonstrated fewer side effects (another story for another post), it does suggest that further study is warranted. So down the road, women may be rubbing all kinds of hormones all over their bodies, not just for hormone replacement in menopause, but to prevent unwanted pregnancy.

But What About Fifi?

This shift towards using creams and gels instead of pills has a surprising down side. You may not know that your pets, your children, and your dude are at risk of being inadvertently exposed to hormones that can cause harmful and undesired side effects. 

The New York Times reported that veterinarians are discovering spayed female pets who appear to go into heat.  They have swollen genitals, bloody discharge, and behavioral issues, even after their ovaries have been removed. Male pets can be affected too. Unintended hormone exposure can lead to swollen breast tissue and hair loss in Spike.

Most commonly, this occurs because the pets are being exposed to skin that has been dosed with hormones over long periods of time. If you’re holding your pet for hours after you apply your hormones, or you fall asleep right next to each other- not just once, but repeatedly, your pet may be at risk.

If the vet doesn’t know that Fifi has been curling up with her owner right after she puts on her estrogen cream, the vet is likely to launch into a long, complicated work-up that might even lead to a second surgery if the vet suspects that ovarian tissue was inadvertently missed during a spay.

It’s Not Just Pets

It’s bad enough that Fifi may wind up getting unnecessary surgery, but when your seven year old daughter winds up with breasts, you’re likely to really freak out. And your doctor is likely to run a whole battery of unnecessary tests. If your child curls up in your arms right after you apply your estrogen to your forearms, and the two of you fall asleep together- frequently- the skin-to-skin contact may be enough to cause problems.

Men can wind up with problems too. If you apply your hormones right before sex or just before cuddling together for a night of spooning, your hormones can rub off on your guy. Is he gonna get boobs? Probably not. Unless you’re taking too many high doses of estrogen than we typically use for menopausal hormone replacement (which the birth control gel could be), he’s unlikely to wind up needing a “bro” (you know - a man bra). But his blood levels could be elevated and could lead to unwelcome side effects.

You Don’t Have To Be Untouchable

Don’t let all this discourage you from using topical hormones.  In my practice at the Owning Pink Center, I used topical hormones all the time- everything from estrogen to progesterone to testosterone. They are well tolerated, easy to manipulate, readily absorbed, and believed to be safer than pills. So if you’re using them, don’t worry. You don’t have to avoid human or animal touch. You just have to be aware and take precautions.

Tips For Reducing Unintended Exposure to Hormones

Peter Koshland, the super-duper awesome compounding pharmacist who runs Koshland Pharmacy in San Francisco offers these tips to help your pets, partner, and children prevent unwanted exposure to hormones.

1. Be mindful about the possibility of transferring your hormones to someone else. Once you know the risk, you’re more likely to be careful. The greatest risk comes from prolonged exposure right after application, such as holding a baby with your bare arms, cuddling your kitty cat, or allowing your pup to lick the cream off your skin. Usually, just knowing the risk is enough to prevent problems.
2. Keep the part of your skin where you apply your hormones covered for at least 2 hours after application. This allows the hormones to absorb and reduces the risk of transference.
3. Apply to a less exposed area. If you normally apply your hormones to your forearms, try applying them to your upper outer arms or your thighs, where you’re less likely to touch another person or animal.
4. Make the switch. If it’s too warm to stay covered, you absolutely must sleep with your bare skin wrapped around your lover, or your life requires frequent exposure to children or animals (such as a day care provider or veterinary technician), you may want to switch to another delivery method for your hormones, such as a patch or sublingual lozenges.

Understanding your body, your hormones, and how to use them safely is all part of owning your health. For more juicy tidbits, read my book What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend. 

Committed to helping you and Fifi stay healthy,

Lissa Rankin, MD

Lissa Rankin, MD: Founder of OwningPink.com, Pink Medicine Woman coach, motivational speaker, and author of What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend and Encaustic Art: The Complete Guide To Creating Fine Art With Wax.