1. Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy
- Author
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Cucinella,Laura, Tiranini,Lara, Cassani,Chiara, Martella,Silvia, Nappi,Rossella E, Cucinella,Laura, Tiranini,Lara, Cassani,Chiara, Martella,Silvia, and Nappi,Rossella E
- Abstract
Laura Cucinella,1,2 Lara Tiranini,1,2 Chiara Cassani,1,3 Silvia Martella,4 Rossella E Nappi1,2 1Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; 2Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy; 3Unit of Obstetrics and Gynecology, IRCCS San Matteo Foundation, Pavia, Italy; 4Unit of Preventive Gynecology, IRCCS European Institute of Oncology, Milan, ItalyCorrespondence: Rossella E Nappi, Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Piazzale Golgi 2, Pavia, 27100, Italy, Tel +390382501561, Fax +390382516176, Email nappi@rossellanappi.comAbstract: Genitourinary syndrome of menopause (GSM) is a frequent consequence of iatrogenic menopause or anti-estrogenic adjuvant therapies in breast cancer survivors (BCSs). GSM may profoundly affect sexual health and quality of life, and a multidimensional unique model of care is needed to address the burden of this chronic heterogeneous condition. Severe symptoms may be insufficiently managed with non-hormonal traditional treatments, such as moisturizers and lubricants, recommended as the first-line approach by current guidelines, because concerns exist around the use of vaginal estrogens, particularly in women on aromatase inhibitors (AIs). Vaginal laser therapy has emerged as a promising alternative in women with GSM who are not suitable or do not respond to hormonal management, or are not willing to use pharmacological strategies. We aim to systematically review current evidence about vaginal laser efficacy and safety in BCSs and to highlight gaps in the literature. We analyzed results from 20 studies, including over 700 BCSs treated with either CO2 or erbium laser, with quite heterogeneous primary outcomes and duration of follow up (4 weeksâ 24 months). Although evidence for laser efficacy in BCSs comes mostly from single-arm
- Published
- 2023