title: ENDOCRINE DILEMMA: Managing menopausal symptoms after breast cancer.
abstract: Managing the symptoms of menopause after a diagnosis of breast cancer offers some unique clinical challenges. For some women, vasomotor symptoms can be severe and debilitating, and hormone therapy is at least relatively contraindicated. Non-oestrogen therapies for hot flushes include SSRIs, clonidine, gabapentin and perhaps black cohosh extracts. Vulvovaginal atrophy can usually be alleviated by simple moisturizers, although some may need specialized physiotherapy such as vaginal dilators. In a small number, topical oestrogens may be the only treatment that works. The CO2 laser may be a novel, non-oestrogen therapy to alleviate this unpleasant symptom. Bone loss can be accelerated in some patients on AIs or those who had early menopause induced by chemotherapy.
authors.affiliation: Barbara Gross Research UnitRoyal Hospital for Women and University of NSW, Locked bag 2000, Randwick, New South Wales 2031, Australia j.eden@unsw.edu.au.
authors.forename: John
authors.initials: J
authors.lastname: Eden
mesh_terms: D000282:Administration, Intravaginal; D000287:Administration, Topical; D001284:Atrophy / Q000628:therapy*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001943:Breast Neoplasms; D031885:Cimicifuga; D003000:Clonidine / Q000627:therapeutic use; D000075202:Contraindications; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D053685:Laser Therapy; D054020:Lasers, Gas; D008593:Menopause; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013565:Sympatholytics / Q000627:therapeutic use; D014621:Vagina / Q000473:pathology*; D014844:Vulva / Q000473:pathology*
chemical_list: D050071:Bone Density Conservation Agents; D003000:Clonidine; D004967:Estrogens; D010936:Plant Extracts; D017367:Selective Serotonin Reuptake Inhibitors; D013565:Sympatholytics