In a nutshell
This review aims to discuss the current treatment options available for genitourinary (GU) symptoms related to menopause in breast cancer (BC) survivors.
Some background
Vulvovaginal atrophy (VVA; thinning, trying, and inflammation of the lining of the vagina) is one of the side effects of hormonal treatments given to patients with BC. VVA involves GU symptoms such as genital itching, pain during intercourse, frequent urination, burning during urination, and frequent urinary infections. These symptoms are today known as the genitourinary syndrome of menopause (GSM).
BC survivors can be affected by GSM as the treatments they receive normally lead to very low levels of estrogen. The most effective treatments for GSM are based on local estrogen therapy. But these treatments are commonly restricted in BC survivors who had hormone-dependant tumors. GSM can affect the quality of life of patients, leading to the stopping of anti-estrogenic treatments.
It was important to review the available treatment options of GSM for BC survivors.
Methods & findings
This article reviewed 29 studies that assessed treatment options for GSM in BC survivors.
Non-hormonal local treatments such as moisturizers and lubricants based on either aqueous gels or autologous platelet-rich plasma and hyaluronic gel were shown to improve dryness and pain during intercourse compared to placebo.
Local estrogen treatment showed improvements in GU symptoms, however with contradictory safety results. Vaginal testosterone administration also showed an improvement in GU symptoms.
Vaginal laser treatment (helps restore blood flow to the vagina and helps the growth of healthy tissue) improved GU symptoms in the short-term and had no reported side effects. However, there was no data regarding BC recurrence.
The bottom line
This article reviewed the current treatment option for GSM in breast cancer survivors.
The fine print
Safety in terms of BC recurrence remains a major concern with all the currently available treatments.
What’s next?
Consult your physician about treatments for VVA/GSM.
Published By :
Maturitas
Date :
Jan 01, 2021
