Simple strategies for vaginal health promotion in cancer survivors.
BACKGROUND
With the population of cancer survivors nearing 12 million, an ever-increasing number of women will face vaginal health issues related to their disease and/or treatment. Abrupt menopause triggered by cancer treatment, for example, can cause intense and prolonged estrogen deprivation symptoms, including vaginal dryness and discomfort. Simple strategies to promote vaginal health are available.


OBJECTIVE
To provide a comprehensive overview of vaginal health issues caused by estrogen deprivation in female cancer patients/survivors and provide recommendations to identify, treat, and promote vaginal health.


METHODS
We describe a treatment algorithm, based on scientific literature and supported by clinical experience, found to be effective in treating these patients at two major cancer centers. We also provide examples of handouts for patient education on vaginal health promotion.


METHODS
Evidence-based medicine and psychosocial literature, in addition to clinical experience at two major cancer centers.


RESULTS
Simple, non-hormonal interventions for sexual dysfunction are often overlooked. Several studies show that education on vaginal lubricants, moisturizers, and dilator use (as needed) can decrease the morbidity of vaginal atrophy. These studies also provide support for our clinical treatment recommendations. Our goal in this article is to increase awareness of these strategies and to provide assistance to general gynecologists and oncologists caring for cancer patients and survivors.


CONCLUSIONS
Dedicating a small amount of time to educate female cancer survivors about methods to promote vaginal health can result in the reduction or elimination of vaginal discomfort. Non-hormonal vaginal health strategies often appear sufficient to remedy these issues. However, large randomized trials are needed, varying the format and components of the treatment program and exploring efficacy in various groups of female cancer survivors.
Carter
Jeanne
J
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. carterj@mskcc.org
Goldfrank
Deborah
D
Schover
Leslie R
LR
D000282:Administration, Intravaginal; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology; D004967:Estrogens / Q000172:deficiency; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D054327:Lubricants / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D010051:Ovarian Neoplasms / Q000150:complications / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D017741:Survivors / Q000523:psychology; D014621:Vagina / Q000473:pathology / Q000503:physiopathology; D014623:Vaginal Diseases / Q000517:prevention & control*
D004967:Estrogens; D054327:Lubricants