title: Current overview of the management of urogenital atrophy in women with breast cancer.
abstract: Systemic treatments for women with breast cancer frequently induce urogenital symptoms that can negatively impact a women's quality of life. Urogenital atrophy is frequently undiagnosed and untreated, particularly in breast cancer survivors. Symptoms of urogenital atrophy can usually be relieved with vaginal estrogen preparations, but risk of recurrence and safety is undefined in women with a history of breast cancer. Treatment with nonhormonal modalities including vaginal moisturizers or lubricants and lifestyle modification are the first lines of management. Low-dose vaginal 17 β-estradiol (vaginal estradiol tablets 10 μg or vaginal estradiol ring) can be considered for the treatment of symptomatic urogenital atrophy in women with a history of breast cancer after appropriate disclosure to the patient. While effective in treating the urogenital symptoms, the safety of such therapy remains uncertain. The decision to offer vaginal estrogen therapy needs to be individualized and should be made jointly with the oncologist.
authors.affiliation: Division of General Internal Medicine and Breast Diagnostic Clinic, Mayo Clinic, Rochester, Minnesota 55905, USA. pruthi.sandhya@mayo.edu
authors.forename: Sandhya
authors.initials: S
authors.lastname: Pruthi
authors.forename: James A
authors.initials: JA
authors.lastname: Simon
authors.forename: Amy P
authors.initials: AP
authors.lastname: Early
mesh_terms: D000282:Administration, Intravaginal; D001284:Atrophy; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D004958:Estradiol / Q000008:administration & dosage / Q000097:blood; D005260:Female; D006801:Humans; D012725:Sexual Behavior; D013739:Testosterone / Q000008:administration & dosage; D014566:Urogenital System / Q000473:pathology*
chemical_list: D013739:Testosterone; D004958:Estradiol