Treatment of climacteric symptoms in survivors of gynaecological cancer.
Different treatments (surgery, radiotherapy, chemotherapy) for gynaecological cancers may cause ovarian failure or increase menopausal symptoms. There is a widespread reluctance among physicians to prescribe hormone replacement therapy (HRT) to the survivors of gynaecological cancer. This review analyses the use of HRT and of alternative therapies in such women. Squamous cervical cancer is not estrogen dependent and thus HRT is not contraindicated. While a cautious approach to hormone-dependent cancer is warranted, for women treated for non-hormone-related tumours alternative treatments for menopausal symptoms should be given due consideration, as any reluctance to prescribe HRT for them has neither a biological nor a clinical basis. In studies of HRT for survivors of endometrial and ovarian cancer, for instance, no evidence of increased risk was found, although no definitive conclusions can yet be formulated. The positive effect of HRT on quality of life seems to outweigh the unfounded suspicion of an increased risk of recurrence of non-hormone-related tumours. Effective non-hormonal alternatives for vasomotor symptoms are selective serotonin reuptake inhibitors and selective serotonin-norepinephrine reuptake inhibitors.
Unit of Obstetrics and Gynaecology, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy. Electronic address: nicoletta.biglia@unito.it.
Nicoletta
N
Biglia
Unit of Obstetrics and Gynaecology, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy.
Valentina Elisabetta
VE
Bounous
Unit of Obstetrics and Gynaecology, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy.
Luca Giuseppe
LG
Sgro
Unit of Obstetrics and Gynaecology, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy.
Marta
M
D'Alonzo
Unit of Obstetrics and Gynaecology, Mauriziano Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin, Italy.
Martina
M
Gallo
D000075202:Contraindications; D004414:Dyspareunia / Q000188:drug therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008593:Menopause; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced*; D011788:Quality of Life; D020919:Sleep Disorders, Intrinsic / Q000188:drug therapy; D017741:Survivors
Cervical cancer; Endometrial cancer; Gynaecological survivors; Hormone replacement therapy (HRT); Ovarian cancer