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The management of menopausal symptoms in breast cancer survivors: case-based approach.
Maturitas 2012; 73(3):265-8M

Abstract

INTRODUCTION

The intensified treatment of breast cancer improves survival but has a price in terms of side-effects. The main side-effects, such as vasomotor symptoms and impaired sexual functioning, are related to premature menopause due to chemotherapy and/or anti-hormonal therapy. Though for some women these symptoms are bearable, for others they have a large impact on their quality of life. The paper discusses the menopausal symptoms most frequently reported by breast cancer survivors and current treatment options.

METHODS

A literature review is presented of menopausal symptoms after breast cancer and management strategies, illustrated by two cases.

SUMMARY

Vasomotor symptoms can be relieved by lifestyle adaptation, acupuncture and non-hormonal agents such as venlafaxine, gabapentin or clonidine. Impaired sexual functioning can be treated by couple-based sexual counselling or psycho-educational therapy. Painful intercourse due to vaginal dryness can be alleviated by vaginal lubricants and moisturizers, but is most effectively treated by vaginal estriol. Local estriol seems safe if used for a short period (less than six weeks). Because of proven increased risk of recurrence with hormone replacement therapy (HRT), it should not be prescribed for breast cancer survivors, although exceptions could be made of selected cases of fully informed BRCA mutation carriers after ER-negative breast cancer and with severe menopausal symptoms due to prophylactic oophorectomy at a young age and (preferably) after mastectomy.

CONCLUSION

The management of vasomotor symptoms and impaired sexual functioning in breast cancer survivors should focus on lifestyle and, if necessary, non-hormonal pharmacological interventions.

Authors+Show Affiliations

Department of Gynecological Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. e.a.g.lammerink@umcg.nlNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22883373

Citation

Lammerink, Ellen A G., et al. "The Management of Menopausal Symptoms in Breast Cancer Survivors: Case-based Approach." Maturitas, vol. 73, no. 3, 2012, pp. 265-8.
Lammerink EA, de Bock GH, Schröder CP, et al. The management of menopausal symptoms in breast cancer survivors: case-based approach. Maturitas. 2012;73(3):265-8.
Lammerink, E. A., de Bock, G. H., Schröder, C. P., & Mourits, M. J. (2012). The management of menopausal symptoms in breast cancer survivors: case-based approach. Maturitas, 73(3), pp. 265-8. doi:10.1016/j.maturitas.2012.07.010.
Lammerink EA, et al. The Management of Menopausal Symptoms in Breast Cancer Survivors: Case-based Approach. Maturitas. 2012;73(3):265-8. PubMed PMID: 22883373.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The management of menopausal symptoms in breast cancer survivors: case-based approach. AU - Lammerink,Ellen A G, AU - de Bock,Geertruida H, AU - Schröder,Carolien P, AU - Mourits,Marian J E, Y1 - 2012/08/09/ PY - 2012/07/09/received PY - 2012/07/13/accepted PY - 2012/8/14/entrez PY - 2012/8/14/pubmed PY - 2013/3/5/medline SP - 265 EP - 8 JF - Maturitas JO - Maturitas VL - 73 IS - 3 N2 - INTRODUCTION: The intensified treatment of breast cancer improves survival but has a price in terms of side-effects. The main side-effects, such as vasomotor symptoms and impaired sexual functioning, are related to premature menopause due to chemotherapy and/or anti-hormonal therapy. Though for some women these symptoms are bearable, for others they have a large impact on their quality of life. The paper discusses the menopausal symptoms most frequently reported by breast cancer survivors and current treatment options. METHODS: A literature review is presented of menopausal symptoms after breast cancer and management strategies, illustrated by two cases. SUMMARY: Vasomotor symptoms can be relieved by lifestyle adaptation, acupuncture and non-hormonal agents such as venlafaxine, gabapentin or clonidine. Impaired sexual functioning can be treated by couple-based sexual counselling or psycho-educational therapy. Painful intercourse due to vaginal dryness can be alleviated by vaginal lubricants and moisturizers, but is most effectively treated by vaginal estriol. Local estriol seems safe if used for a short period (less than six weeks). Because of proven increased risk of recurrence with hormone replacement therapy (HRT), it should not be prescribed for breast cancer survivors, although exceptions could be made of selected cases of fully informed BRCA mutation carriers after ER-negative breast cancer and with severe menopausal symptoms due to prophylactic oophorectomy at a young age and (preferably) after mastectomy. CONCLUSION: The management of vasomotor symptoms and impaired sexual functioning in breast cancer survivors should focus on lifestyle and, if necessary, non-hormonal pharmacological interventions. SN - 1873-4111 UR - https://www.unboundmedicine.com/medline/citation/22883373/The_management_of_menopausal_symptoms_in_breast_cancer_survivors:_case_based_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-5122(12)00243-5 DB - PRIME DP - Unbound Medicine ER -