Practical clinical guidelines for assessing and managing menopausal symptoms after breast cancer

Ann Oncol. 2008 Oct;19(10):1669-80. doi: 10.1093/annonc/mdn353. Epub 2008 Jun 2.

Abstract

Background: The purpose of this study was to provide practical, evidence-based guidelines for evaluating and treating common menopausal symptoms following breast cancer.

Methods: Literature review of the causes, assessment and management of menopausal symptoms in breast cancer patients.

Results: A number of nonhormonal treatments are effective in treating hot flashes. Whether pharmacological treatment is given will depend on the severity of symptoms and on patient wishes. For severe and frequent hot flashes, the best data support the use of venlafaxine, paroxetine and gabapentin in women with breast cancer. Side-effects are relatively common with all these agents. For vaginal dryness, topical estrogen treatment is the most effective but the safety of estrogens following breast cancer is not established. There are limited data on effective treatments for sexual dysfunction during menopause.

Conclusion: Menopausal symptoms after breast cancer should be evaluated and managed as warranted using a systematic approach and may benefit from multidisciplinary input.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / adverse effects
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Breast Neoplasms / physiopathology*
  • Breast Neoplasms / therapy
  • Estrogen Antagonists / adverse effects
  • Estrogen Antagonists / therapeutic use
  • Female
  • Hot Flashes / drug therapy
  • Hot Flashes / etiology
  • Hot Flashes / therapy*
  • Humans
  • Ovariectomy / adverse effects
  • Sexual Dysfunction, Physiological / drug therapy*
  • Sexual Dysfunction, Physiological / etiology
  • Vaginitis / drug therapy*
  • Vaginitis / etiology

Substances

  • Antineoplastic Agents, Hormonal
  • Estrogen Antagonists