Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

Journal of Personalized Medicine

Joanne Lester¹  Maryam Lustberg²  Barbara Andersen³  Gaurav Pahouja⁴ 

[1] Clinical Research Nurse Practitioner, Division of Surgical Oncology, The Ohio State University, Columbus, OH 43210, USA;Comprehensive Cancer Center, Arthur G. James Comprehensive Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH 43210, USA;Department of Psychology, The Ohio State University, Columbus, OH 43210, USA;Northeast Ohio Medical University, Rootstown, OH 44272, USA;

关键词: atrophic vaginitis;    breast cancer;    vaginal dryness;    dyspareunia;    vaginal estrogen;    survivorship;    chemotherapy-induced ovarian failure;    endocrine therapy;    breast cancer;    non-hormonal vaginal therapy;   

DOI  :  10.3390/jpm5020050

来源: DOAJ

【 摘 要 】

Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors.

【 授权许可】

Unknown