Preserving vaginal health after treatment for gynecological malignancies

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Abstract

The prevalence of vaginal atrophy is particularly high among women who have undergone treatment for gynecological cancers, since they have significantly lower estrogen levels and altered vaginal microbiota. These patients often experience vaginal discomfort, dryness, and pain, but rarely report this to a doctor. Such symptoms affect patients’ quality of life and might cause a family breakdown. This article proposes a safe therapeutic option for women with vulvovaginal atrophy resulted from gynecological surgeries or comprehensive treatment for gynecological cancers. It provides a rationale for the local application of Estrogial™ containing hyaluronic acid. Elimination of symptoms, such as burning, itching, swelling, and hyperemia of the vulval vestibule and perineal tissues ensured maximum compliance to treatment in cancer patients and improved their quality of life after combination therapy.

About the authors

A. G. Kedrova

Department of Oncology, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical and Biological Agency of the Russian Federation

Author for correspondence.
Email: kedrova.anna@gmail.com
ORCID iD: 0000-0003-1031-9376

Anna G. Kedrova.

28 Orekhovyy Bulvar, Moscow 115682

Russian Federation

References

  1. Perez-Lopez F.R., Phillips N., Vieira-Baptista P. et al. Management of postmenopausal vulvovaginal atrophy: recommendations of the International Society for the Study of Vulvovaginal Disease. Gynecol Endocrinol 2021;37(8):746-52. doi: 10.1080/09513590.2021.1943346
  2. Simon J.A., Goldstein I., Kim N.N. et al. The role of androgens in the treatment of genitourinary syndrome of menopause (GSM): International Society for the Study of Women's Sexual Health (ISSWSH) expert consensus panel review. Menopause 2018;25:837-47. DOI: 0.1097/GME.0000000000001138
  3. Jakesz R., Jonat W., Gnant M. et al. Switching of postmenopausal women with endocrine-responsive early breast cancer to anastrozole after 2 years' adjuvant tamoxifen: Combined results of ABCSG trial 8 and ARNO 95 trial. Lancet 2005;366:455-62. doi: 10.1016/S0140-6736(05)67059-6
  4. Situtation with cancer care in Russia in 2021. Ed. by A.D. Kaprin, V.V. Starinskiy, A.O. Shakhzodova. Moscow: P.A. Herzen Moscow Oncology Research Institute - a branch of the National Medical Research Radiological Center, Ministry of Health of Russia, 2022. 239 p. (In Russ.)
  5. Bachmann G.A. Vulvo-vaginal complaints. In: Treatment of the Postmenopausal Woman. New York: Raven Press, 1994.
  6. The North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause 2013;20:888-902.
  7. Stika C.S. Atrophic vaginitis. Dermatol Ther 2010;23:514-22. doi: 10.1111/j.1529-8019.2010.01354.x
  8. Loibl S., Lintermans A., Dieudonne A.S., Neven P. Management of menopausal symptoms in breast cancer patients. Maturitas 2011;68:148-54. doi: 10.1016/j.maturitas.2010.11.013
  9. Tan O., Bradshaw K., Carr B.R. Management of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women: An up-to-date review. Menopause 2012;19:109-17.
  10. Lester J.L., Bernhard L.A. Urogenital atrophy in breast cancer survivors. Oncol Nurs Forum 2009;36:693-8. doi: 10.1188/09.ONF.693-698
  11. Chin S.N., Trinkaus M., Simmons C. et al. Prevalence and severity of urogenital symptoms in postmenopausal women receiving endocrine therapy for breast cancer. Clin Breast Cancer 2009;9:109-17. doi: 10.3816/CBC.2009.n.020
  12. Palma F., Xholli A., Cagnacci A. et al. The most bothersome symptom of vaginal atrophy: evidence from the observational AGATA study. Maturitas 2018;108:18-23. DOI: 10.1016/j. maturitas.2017.11.007
  13. Cagnacci A., Barattini D.F., Casolati E. et al. Polycarbophil vaginal moisturizing gel versus hyaluronic acid gel in women affected by vaginal dryness in late menopausal transition: A prospective randomized trial. Eur J Obstet Gynecol Rep Biol 2022;270;239-45. doi: 10.1016/j.ejogrb.2022.01.021
  14. Kedrova A.G. Prevention of vaginal atrophy after treatment for gynecological malignancies. Opukholi zhenskoy reproduktivnoy sistemy = Tumors of Female Reproductive System 2019;15(4): 73-8. (In Russ.)
  15. Traish A.M., Vignozzi L., Simon J.A. et al. Role of androgens in female genitourinary tissue structure and function: implications in the genitourinary syndrome of menopause. Sex Med Rev 2018;6:558-71. doi: 10.1016/j.sxmr.2018.03.005
  16. Nappi R.E. New attitudes to sexuality in the menopause: clinical evaluation and diagnosis. Climacteric 2007;10(Suppl 2):105-8. doi: 10.1080/13697130701599876
  17. Goldstein I. Recognizing and treating urogenital atrophy in postmenopausal women. J Womens Health 2010;19:425-32. doi: 10.1089/jwh.2009.1384
  18. Trinkaus M., Chin S., Wolfman W. et al. Should urogenital atrophy in breast cancer survivors be treated with topical estrogens? Oncologist 2008;13:222-31. doi: 10.1634/theoncologist.2007-0234
  19. Apolikhina I.A., Yureneva S.V., Malyshkina D.A. Genitourinary syndrome of menopause: current approaches to the diagnosis and treatment. Akusherstvo i ginekologiya = Obstetrics and Gynecology 2020;12(Supplement):4-8. (In Russ.)
  20. Tikhomirova E.V., Balan V.E., Kruchinina E.V. et al. Utility of non-hormonal therapy for genitourinary syndrome of menopause. Effektivnaya farmakoterapiya = Effective Pharmacotherapy 2022;18(34):6-12. (In Russ.)
  21. Shaposhnikova E.V. Utility of non-hormonal therapy in patients with vulvovaginal atrophy. Rossiyskiy vestnik akushera-ginekologa = Russian Bulletin of Obstetrician-Gynecologist 2020;20(4):58-64. doi: 10.17116/rosakush20202004158. (In Russ.).

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