Treatment of Genitourinary Syndrome of Menopause in Breast Cancer and Gynecologic Cancer Survivors:Retrospective Analysis of Efficacy and Safety of Vaginal Estriol, Vaginal Dehydroepiandrosterone and Ospemifene
- Author:
Ermelinda PENNACCHINI
1
;
Roberta DALL’ALBA
;
Silvia IAPAOLO
;
Matilde MARINELLI
;
Pier Luigi PALAZZETTI
;
Marzio Angelo ZULLO
;
Mauro CERVIGNI
;
Andrea MORCIANO
;
Lorenzo CAMPANELLA
;
Benedetto FERRARESI
;
Michele Carlo SCHIAVI
Author Information
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Menopausal Medicine 2024;30(3):170-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:To compare the efficacy and safety of three different treatment options (vaginal estriol, vaginal dehydroepiandrosterone (DHEA), and ospemifene) for treating genitourinary syndrome of menopause (GSM) in breast cancer and gynecologic cancer survivors.
Methods:A retrospective comparative analysis was performed among 185 cancer survivors (including breast, endometrial, ovarian, cervical, and vulvar cancer) affected by GSM. Women were divided into three groups according to the prescribed therapy (vaginal estriol, vaginal DHEA, and ospemifene). Safety and efficacy of therapies were assessed over a 6-month follow-up. Improvement in symptoms was compared using the following questionnaires: Female Sexual Function Index, Female Sexual Distress Scale, Visual Analogue Scale (VAS)-dyspareunia, VAS-vulvar pain, Short Form (36) Health Survey, and Patients’ Impression of Global Improvement. Cancer recurrence was evaluated according to oncological protocol.
Results:After the 6-month follow-up, no significant endometrial thickening or cancer recurrence was observed in any group. The rate of sexually active women significantly increased in all groups, as well as the frequency of sexual intercourse. Scores on questionnaires assessing women’s sexual function significantly improved in all patients. Women also complained of less vulvar pain and dyspareunia.Safety and efficacy of treatment were comparable between the three groups for all items except for dyspareunia. Patients taking ospemifene complained of less dyspareunia than those receiving local hormone treatment.
Conclusions:Vaginal estriol, vaginal DHEA, and ospemifene were effective in improving symptoms of GSM in cancer survivors and were not associated with cancer recurrence over the 6-month follow-up. Ospemifene was more effective than local hormones in treating dyspareunia.
