Hi ladies, I wanted to give you all a quick update and say a huge thank you for your advice!
I had my ultrasound this morning. I took the advice to tell the tech right from the start about my vaginal dryness from letrozole. The tech was incredible—she reassured me that she would capture as much as possible with external imaging first, just in case the internal scan was too uncomfortable to evaluate the cysts. She also had me insert the probe myself, and while it was uncomfortable, it was not painful at all. I couldn't have asked for a kinder tech!
To top it off, as I was putting on my shoes, I mentioned that she reminded me of someone I used to do Zumba with at the gym. Turns out, it was actually her! Between her mask,my mask and only ever seeing each other in gym clothes, neither of us recognized the other at first. It turned what could have been a stressful appointment into such a comforting, small-world moment.
Thank you all for your advice.
PS: The olive oil has been helping me. I apply it everday after a shower.

This sounds like good advice. When I'm in stressful testing situations, I like to scan my body and focus on relaxing one little area at a time... like eyes, nose, jaw, neck, shoulder, etc. It distracts me and makes the time go a bit faster. I used it during my last MRI, as well as my CT scans, PET scan, ultrasounds, biopsy..... sending you lots of healing energy!

Thank you LoriRatcliff. My PC doctor said the same thing about vaginal administered estradiol. She said that while absorption into the blood stream is minimal ,with prolonged usage it can still raise hormone levels in the blood. The bottom line is they aren't very sure if,how and when it can enter the blood stream.

I would urge caution about using any vaginal cream that has estrogen in it if your BC was hormone positive. I know some doctors say it doesn't get absorbed into your system but my oncologists both said they don't really know that for sure and it's not worth the risk. I was on Estriodol before my diagnosis and got off of it immediately.

I'm a couple weeks into using hyaluronic acid vaginal suppositories... It's one of those things where you have to use them long term, but you can use them less the longer that you're on them. The big name brand ones are so ridiculously expensive, so I decided to try the CVS pharmacy brand (still not cheap at $20 a box but not as bad as the other brands) and I genuinely feel like they are helping me a lot! I'd definitely recommend you give them a try! It's a soft insert and I put one in just before bedtime, so that it doesn't melt and all run out. Right now I use it about every other day, or every 2 days... and I'm going to gradually decrease to where I'm just doing maybe 2 or 3 times a week. For external moisturizing, I use an organic jojoba oil... it's the closest to the natural oils that our skin secretes.
I was having trouble finding the product at my local CVS so I had to order it online. When it arrived to me it had melted because of how hot it is, but I put them in the refrigerator and they firmed right back up.