Emerging Use of Vaginal Laser to Treat Genitourinary Syndrome of Menopause for Breast Cancer Survivors: A Review

Jugulytė, Nida; Žukienė, Guoda; Bartkevičienė, Daiva

doi:10.3390/medicina59010132

Cited by 12 publications

(17 citation statements)

References 69 publications

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“…Staying sexually active helps by increasing blood flow to the vagina. Against urinary incontinence, pelvic floor muscles can be strengthened with simple and effective physical exercises that must always be performed under competent guidance (such as a physiotherapist or a professional nurse) and tend to strengthen the pelvic floor [205][206][207][208][209][210][211][212][213].…”

Section: Discussionmentioning

confidence: 99%

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

Comparetto,

Borruto

2023

OBM Geriatr

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In the United States (US), menopause occurs at an average age of 52. Menopausal symptoms tend to be maximal during the few years before and the year after menopause (during perimenopause), except for symptomatic vulvovaginal atrophy, which may worsen over time. Up to 20% of bone density loss occurs during the first 5 years after menopause, followed by an age-related bone loss rate similar to that in men. Menopause should be considered confirmed if an age-appropriate woman who is not pregnant has not had a menstrual period for 12 months. Regarding treatment, for vaginal dryness or dyspareunia due to menopause, vaginal stimulation and vaginal lubricants and moisturizers are recommended, and if these are ineffective, low-dose vaginal estrogen, in the form of creams, tablets, suppositories, or rings should be considered; other options include oral ospemifene or intravaginal dehydroepiandrosterone (DEHA) suppositories. Before prescribing hormone replacement therapy (HRT) and periodically while therapy continues, women should be informed of risks (e.g., deep vein thrombosis [DVT], pulmonary embolism [PE], stroke, breast cancer, gallbladder disease, and urinary incontinence); potential harms are greatest for women who start HRT after 60 years of age or who are 10-20 years past menopause onset. If women choose HRT to relieve hot flushes, estrogen plus, a progestin or conjugated estrogen/bazedoxifene could be prescribed for women who still have the uterus. Treatment with HRT should be tailored to maximize benefits and minimize harms, and periodically benefits and harms should be reassessed; low-dose transdermal HRT may lead to a lower risk of DVT and stroke. Selective serotonin reuptakereuptake inhibitors (SSRIs), selective serotonin-nor-epinephrine reuptake inhibitors (SNRIs), and gabapentin could be considered as less effective alternatives to HRT for relieving hot flushes; paroxetine 7.5 milligrams (mg) is the only non-hormonal drug approved in the US for the relief of hot flushes. Effective non-drug options include cognitive behavioral therapy and hypnosis.

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Section: Discussionmentioning

confidence: 99%

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

Comparetto,

Borruto

2023

OBM Geriatr

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“…A double-blind, sham-controlled RCT of 84 breast cancer survivors on AI showed neither adverse nor beneficial effects in either objective or subjective measures comparing the laser and sham groups 24 . Further evaluation is needed to confirm the benefits of vaginal laser therapy for GSM and assess its long-term effects in cancer survivors 25 …”

Section: Treating Gsm In Cancer Survivorsmentioning

confidence: 99%

“…23 Because the effects of ospemifene on the breast are not well established, it is not 24 Further evaluation is needed to confirm the benefits of vaginal laser therapy for GSM and assess its longterm effects in cancer survivors. 25 Hersant et al 26 evaluated a novel approach to treatment of GSM in a pilot study of 20 breast cancer survivors who underwent intramucosal vaginal injections of platelet-rich plasma along with hyaluronic acid and showed significant improvements in the vaginal health index at 6 months. Future trials are needed to see whether novel approaches like this that promote tissue repair will prove beneficial for cancer survivors.…”

Section: Hormonal Therapiesmentioning

confidence: 99%

Genitourinary Syndrome of Menopause in Cancer Survivors

DUGAN,

OTHIENO,

GOLDMAN

2023

Clinical Obstetrics &Amp; Gynecology

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Genitourinary syndrome of menopause (GSM) encompasses the symptoms of estrogen deprivation in the vaginal, vulva, and bladder areas. Because many cancer treatments induce a hypoestrogenic state, GSM is common in cancer survivors. The number of cancer survivors is increasing, and the unique aspects of GSM management for cancer survivors, such as the safety of hormonal therapies, is important to understand. In this review, we cover important considerations in the assessment of GSM; nonpharmacologic, behavioral, integrative, pharmacologic, and medical device treatments for GSM: the unique considerations in GSM by cancer treatment modality; bladder manifestations of GSM; and GSM in specific populations.

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“…The two most extensively researched lasers for alleviating GSM symptoms are the non-ablative erbium-doped yttrium aluminum garnet laser (Er:YAG) laser and microablative fractional carbon dioxide (CO 2 ) laser [ 43 ]. These two lasers have different characteristics, such as the active medium, wavelength, and water absorption.…”

Section: Reviewmentioning

confidence: 99%

Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

Okui

2023

Cureus

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Vulvovaginal atrophy (VVA) is a chronic condition resulting from reduced estrogen levels during menopause. The North American Menopause Society and the International Society for the Study of Women's Sexual Health suggested the term "genitourinary syndrome of menopause" (GSM) to indicate the broader aspects of VVA. Breast cancer treatments, such as chemotherapy and endocrine therapy, can induce early and abrupt menopausal symptoms, including GSM, which negatively affects sexual function and the quality of life of the survivors. Vaginal laser therapy has emerged as a safe and effective option for the management of GSM in breast cancer survivors (BCSs). Two main types of lasers, the non-ablative erbium:YAG laser and fractional microablative CO 2 vaginal laser, have been evaluated for GSM treatment. While there are few randomized controlled trials (RCTs) on the subject of BCSs, a wealth of prospective and retrospective studies have highlighted the beneficial effects of vaginal laser therapy on the symptoms of VVA, vaginal health, sexual function, and overall quality of life. More comprehensive research is essential to confirm its enduring effectiveness and safety, with a focus on conducting standardized and meticulously controlled investigations. This study is a narrative review that summarizes clinical trials ranging from the earliest to the most recent ones on laser treatment for GSM in BCSs.

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Emerging Use of Vaginal Laser to Treat Genitourinary Syndrome of Menopause for Breast Cancer Survivors: A Review

Cited by 12 publications

References 69 publications

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

Genitourinary Syndrome of Menopause in Cancer Survivors

Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

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