Treatment of climacteric symptoms in survivors of gynaecological cancer

Maturitas
Nicoletta BigliaMartina Gallo

Abstract

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.

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Citations

Jun 28, 2017·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Hui Pang, Xiuying Yue
Jan 24, 2018·Nature Reviews. Clinical Oncology·Ines Vaz-Luis, Ann H Partridge
Sep 7, 2018·Expert Review of Anticancer Therapy·Rosaria Condorelli, Ines Vaz-Luis
Jan 9, 2019·Pathology Oncology Research : POR·Tamás DeliAttila Jakab
Dec 4, 2015·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Zhen LiHongbing Cai
Jan 29, 2020·The Cochrane Database of Systematic Reviews·Nungrutai SaeaibEva Myriokefalitaki
Nov 19, 2019·Menopause : the Journal of the North American Menopause Society·Benjamin S HarrisThomas M Price

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