Abstract
Women who have been treated for breast cancer may experience vulvo-vaginal atrophy (VVA)/genitourinary syndrome of menopause (GSM). This is a progressive condition and will not improve without treatment. Whilst vaginal oestrogen is the most effective treatment for GSM, many breast cancer survivors and clinicians remain reluctant to use it. Laser therapy is emerging as an alternative treatment for this condition but there is little evidence available as to its value in this setting.We undertook a systematic literature review to identify available evidence for the use of laser therapy for VVA in women with breast cancer. There are a number of small studies which suggest an improvement in vaginal health in this group. However, these are all small, non-randomised studies and there are a number of key questions which need to be answered before this treatment can be implemented into practice.
Highlights
Vulvovaginal atrophy (VVA), which is known as genitourinary syndrome of menopause (GSM), results due to the natural hypo-oestrogenic state that occurs during and following menopause
50% of post-menopausal women will suffer from GSM [20]
There are a number of small-scale studies which all suggest an improvement in vaginal health in women who have had breast cancer, both objectively and subjectively
Summary
Vulvovaginal atrophy (VVA), which is known as genitourinary syndrome of menopause (GSM), results due to the natural hypo-oestrogenic state that occurs during and following menopause. 50% of post-menopausal women will suffer from GSM (reported incidence is between 39% and 62%) [20]. Up to 75% of women surviving breast cancer are expected to experience GSM [27], because they are either post-menopausal at diagnosis or they have become menopausal as a result of endocrine or chemotherapy. GSM is progressive in nature; it will only deteriorate with time and will not improve without intervention. This can have a significant effect on the quality of life (QoL) [7]
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