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Olubukola Ayodele: Genitourinary syndrome of menopause

Olubukola Ayodele/LinkedIn

Nov 29, 2024, 16:09

Olubukola Ayodele: Genitourinary syndrome of menopause

Olubukola Ayodele, Consultant Medical Oncologist at the University Hospitals of Leicester NHS Trust, shared a post on LinkedIn:

“Let’s discuss a challenging issue many women face—genitourinary syndrome of menopause (GSM), which is caused by decreased estrogen levels leading to symptoms like vaginal dryness, painful intercourse, frequent urination, and pelvic pain.

This condition is particularly common among breast cancer survivors, especially those with hormone receptor-positive breast cancer, as their treatments often lower estrogen levels. Hormone receptor-positive breast cancer accounts for about 70-80% of breast cancer cases making it the most common breast cancer subtype. Developing GSM often adds another layer of difficulty during an already challenging time for many patients.

Vaginal estrogen is an effective treatment for GSM; however, fear of estrogen’s impact post breast cancer often leads to hesitancy among healthcare providers to prescribe it.

Emerging research offers reassurance, showing vaginal estrogen does not increase the risk of breast cancer recurrence or mortality.

Recent studies include:

1. A 2022 observational study by Cold et al. found no increased breast cancer recurrence risk in a cohort of over 8,000 postmenopausal women.

2. A November 2023 cohort study by McVicker et al. involving over 49,000 women reported no increased early mortality with vaginal estrogen use.

3. A comprehensive systematic review by Beste et al. published in November 2024 analyzed nearly 6,000 articles and also found no increase in recurrence or mortality related to vaginal estrogen.

Addressing GSM is crucial, as it can lead to non-compliance with hormonal therapy. As the incidence of breast cancer in younger women continues to rise, it is important for healthcare providers to support women in accessing treatments that can improve their quality of life.”

Olubukola Ayodele: Genitourinary syndrome of menopause