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Modern approach to the management of genitourinary syndrome in women with gynecological malignancies

Nina Kovacevic
Nina Kovacevic
, 
Ines Cilensek
Ines Cilensek
, 
Sebastjan Merlo
Sebastjan Merlo
 oraz 
Barbara Segedin
Barbara Segedin
   | 26 lip 2023
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Article Category: Review
Data publikacji: 26 lip 2023
Zakres stron: 292 - 298
Otrzymano: 15 maj 2023
Przyjęty: 25 cze 2023
DOI: https://doi.org/10.2478/raon-2023-0038
Słowa kluczowe
© 2023 Nina Kovacevic et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Pharmacological and non-pharmacological treatment modalities for the genitourinary syndrome of menopause

Pharmacological treatment Non-pharmacological treatment
Hormone therapy Lifestyle changes
SERM Vaginal lubricants
DHEA Vaginal moisturizers
Testosteron Laser therapy
Lidocain Vaginal dilatators

Genital, urinary, and sexual signs and symptoms of genitourinary syndrome of menopause

Genital Urinary Sexual
Vaginal dryness Dysuria Dyspareunia
Vaginal irritation Urgency Decreased lubrication
Vaginal burning Frequency Postcoital bleeding and spotting
Vaginal itching Reccurent urinary tract infections Decreased arousal
Vulvar pruritus Cystocele Dysorgasmia
Thinning and graying pubic hair Stress urinary incontinence Loss of libido
Vaginal/pelvic pain and pressure Urge urinary incontinence Loss of arousal
Vaginal vault prolapse Hematuria Pelvic pain
Vaginal and introital stenosis Nocturia
Palor of vaginal mucosa
Fewer vaginal rugae
Petechiae in vaginal and cervical mucosa
Labial shrinking and atrophia

Recommendations for hormone therapy in women treated for gynecological malignancies

Gynecological malignancy Recommendation Selected articles Level of evidence Note
Uterine cancer
Early stage endometrial cancer HT acceptable Barakat et al. 200631 randomized control trial 1236 patients, no difference in recurrence rate with the use of HT
Shim et al. 201432 meta-analysis no increased risk of recurrence
Advanced stage endometrial cancer HT not recommended Sinno et al. 20202 NAMS clinical practice statement no data supporting use of HT
Uterine sarcoma HT not recommended George et al. 201421 phase 2 trial 27 patients, a potential response to anti-estrogen therapy (Letrozole)
Sinno et al. 20202 NAMS clinical practice statement lack of data regarding HT safety
Ovarian cancer
High grade serous HT acceptable Li et al. 201533 meta-analysis HT is not associated with poorer clinical outcome, epithelial ovarian cancers
Low grade serous HT not recommended Gershenson et al. 201234 retrospective study 64 patients, high rate of hormone receptor expression and maintenance anti-endocrine therapy
Sinno et al. 20202 NAMS clinical practice statement not sufficient safety data available
Endometrioid HT acceptable Power et al. 201635 retrospective cohort data 391 patients, HT is not associated with decreased disease-free or overall survival
Clear cell HT not recommended Didar et al. 202322 meta-analysis increased risk of venous thromboembolism events
Mucinous HT acceptable Li et al. 201533 meta-analysis HT is not associated with poorer clinical outcome, epithelial ovarian cancers
Cervical cancer HT acceptable Ploch et al. 198736 prospective study 120 patients, no difference in recurrence rate with the use of HT
eISSN:
1581-3207
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
Kanał RSS czasopisma