title: Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study.
abstract: The study aim is to evaluate the efficacy and safety of two low-dose vaginal estrogen treatments (ETs) and of a non-hormonal vaginal moisturizer in postmenopausal breast cancer survivors with urogenital atrophy. Eighteen patients receiving estriol cream 0.25 mg (n = 10) or estradiol tablets 12.5 microg (n = 8) twice/week for 12 weeks were evaluated and compared with eight patients treated with polycarbophil-based moisturizer 2.5 g twice/week. Severity of vaginal atrophy was assessed using subjective [Vaginal Symptoms Score (VSS), Profile of Female Sexual Function (PFSF)] and objective [Vaginal Health Index (VHI), Karyopycnotic Index (KI)] evaluations, while safety by measuring endometrial thickness and serum sex hormones levels. After 4 weeks, VSS and VHI were significantly improved by both vaginal ETs, with further improvement after 12 weeks. PFSF improved significantly only in estriol group (p = 0.02). Safety measurements did not significantly change. Vaginal moisturizer improved VSS at week 4 (p = 0.01), but score returned to pre-treatment values at week 12; no significant modification of VHI, KI, PFSF was recorded. Both low-dose vaginal ET are effective for relieving urogenital atrophy, while non-hormonal moisturizer only provides transient benefit. The increase of serum estrogens levels during treatment with vaginal estrogen at these dosages is minimal.
authors.affiliation: Department of Oncological Gynaecology, University of Turin, Institute for Cancer Research and Treatment of Candiolo (IRCC), Turin, Italy. nicoletta.biglia@unito.it
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Biglia
authors.forename: Elisa
authors.initials: E
authors.lastname: Peano
authors.forename: Paola
authors.initials: P
authors.lastname: Sgandurra
authors.forename: Giulia
authors.initials: G
authors.lastname: Moggio
authors.forename: Enrico
authors.initials: E
authors.lastname: Panuccio
authors.forename: Marco
authors.initials: M
authors.lastname: Migliardi
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Ravarino
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ponzone
authors.forename: Piero
authors.initials: P
authors.lastname: Sismondi
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage* / Q000494:pharmacology; D000282:Administration, Intravaginal; D001284:Atrophy; D001943:Breast Neoplasms; D004958:Estradiol / Q000008:administration & dosage* / Q000494:pharmacology; D004964:Estriol / Q000008:administration & dosage* / Q000494:pharmacology; D004967:Estrogens / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D014621:Vagina / Q000187:drug effects* / Q000473:pathology*; D014622:Vaginal Creams, Foams, and Jellies
chemical_list: D000180:Acrylic Resins; D004967:Estrogens; D014622:Vaginal Creams, Foams, and Jellies; D004958:Estradiol; C030312:calcium polycarbophil; D004964:Estriol