TY - JOUR
T1 - Genitourinary syndrome of menopause in breast cancer survivors
T2 - Are we facing new and safe hopes?
AU - Biglia, Nicoletta
AU - Bounous, Valentina E.
AU - Sgro, Luca G.
AU - D'Alonzo, Marta
AU - Pecchio, Silvia
AU - Nappi, Rossella E.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - 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.
AB - 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.
KW - BCS
KW - GSM
KW - Iatrogenic menopause
KW - Treatment
KW - Vulvovaginal atrophy (VVA)
UR - http://www.scopus.com/inward/record.url?scp=84947040451&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947040451&partnerID=8YFLogxK
U2 - 10.1016/j.clbc.2015.06.005
DO - 10.1016/j.clbc.2015.06.005
M3 - Article
C2 - 26198332
AN - SCOPUS:84947040451
VL - 15
SP - 413
EP - 420
JO - Clinical Breast Cancer
JF - Clinical Breast Cancer
SN - 1526-8209
IS - 6
ER -