Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Are We Facing New and Safe Hopes?

Abstract Breast cancer survivors (BCSs) often suffer from menopausal symptoms induced by systemic treatments, with a consequent negative effect on quality of life. Since the introduction of aromatase inhibitors as the standard therapy for hormone-dependent tumors, genitourinary syndrome of menopause...

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Bibliographic Details
Published in:Clinical breast cancer 2015-12, Vol.15 (6), p.413-420
Main Authors: Biglia, Nicoletta, Bounous, Valentina E, Sgro, Luca G, D'Alonzo, Marta, Pecchio, Silvia, Nappi, Rossella E
Format: Article
Language:English
Subjects:
Antineoplastic Agents, Hormonal - adverse effects
BCS
Breast Neoplasms - drug therapy
Female
Female Urogenital Diseases - chemically induced
GSM
Hematology, Oncology and Palliative Medicine
Humans
Iatrogenic menopause
Menopause - drug effects
Obstetrics and Gynecology
Survivors
Syndrome
Treatment
Vulvovaginal atrophy (VVA)
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Summary:Abstract Breast cancer survivors (BCSs) often suffer from menopausal symptoms induced by systemic treatments, with a consequent negative effect on quality of life. Since the introduction of aromatase inhibitors as the standard therapy for hormone-dependent tumors, genitourinary syndrome of menopause (GSM) has become a main problem for BCSs. This new terminology refers to the wide range of vaginal and urinary symptoms related to menopause, which can be relieved by estrogen therapy. Unfortunately, systemic hormone therapy is contraindicated for BCSs and also vaginal estrogens at standard dosage might influence the risk of recurrence because they cause a significant increase of circulating estrogens. Nonhormonal vaginal moisturizers or lubricants are the first choice for BCSs but only have limited and short-term efficacy. New strategies of management of GSM are now available, including: (1) low-dose or ultra low-dose vaginal estrogens; (2) oral selective estrogen receptor modulators (ospemifene); (3) androgen therapy; (4) physical treatment with vaginal laser; and (5) psychosocial interventions. In this review we discuss and analyze these different options.
ISSN:1526-8209
1938-0666
DOI:10.1016/j.clbc.2015.06.005