Safety of vaginal oestrogens for genitourinary symptoms in women with breast cancer.

Abstract

Oestrogen deprivation is the mainstay oftreatment for women with hormone receptor-positive breast cancer, but unfortunately it causes multiple side effects that can significantly impair quality of life. Genitourinary symptoms are very common and although these symptoms can be effectively managed with vaginal oestrogens, concerns about their safety in women with breast cancer limits their use. The aim of this review is to provide a summary of the data on the safety of vaginal oestrogens in women with breastcancer to help general practitioners advise their patients in this situation. Although there are no large randomised prospective studies to assess safety, the current evidence suggests reassurance can be provided to the majority of womenwith a history of breast cancer considering vaginal oestrogens. Consultation with the oncology team isadvised for women taking aromatase inhibitors, where the safety of vaginal oestrogens is less certain.