Menopausal replacement therapy following the treatment of gynaecological malignancies including the breast

Abstract

Gynaecological malignancies have been known to be prevalent among the postmenopausal category of women, although a considerable fraction is being increasingly diagnosed in the premenopausal age group as well. Owing to the improvement in survival rates among women who are being diagnosed with gynaecological malignancies in recent times, the need to improve the quality of life among these women has become imperative. Standard treatment regimens for gynaecological malignancies include surge1y, chemotherapy and radiotherapy and these are known to cause a prolonged oestrogen deficiency which inevitably leads to menopause in younger women. Therefore, it is essential to formulate an appropriate strategy to overcome this concern. This article focuses on the benefits of MRT in women following menopause after having been subjected to standard therapeutic methods for gynaecological malignancies. It also scrutinizes whether the benefits outweigh the risk of recurrence in women suffering from ovarian, endometrial, cervical, vaginal and vulval malignancies. In addition, this article also focuses on the use of MRT before (the at-risk population), and after breast cancer. Estrogen alone MRT is considered safe carrying no or similar· risks among the population. Among those whose symptoms are refractory, MRT can be considered, but it should only be prescribed following a careful discussion between the patient and a breast specialist.