The Safety of Local Hormonal Treatment for Vulvovaginal Atrophy in Women With Estrogen Receptor-Positive Breast Cancer on Adjuvant Aromatase Inhibitor Therapy: Meta-Analysis

    August 2019 in “ Clinical breast cancer ”
    Radiša Pavlović, Slobodan M. Janković, Jasmina Milovanović, S Stefanović, Marko Folić, Olivera Milovanović, Chaitanya Mamillapalli, Miloš Milosavljević
    TLDR Local hormonal treatment for vulvovaginal atrophy is likely safe for women with estrogen receptor-positive breast cancer on aromatase inhibitors.
    The meta-analysis aimed to evaluate the safety of local hormonal treatment for vulvovaginal atrophy in women with estrogen receptor-positive breast cancer who are on adjuvant aromatase inhibitor therapy. Eleven studies were included in the analysis. The results showed that after 8 weeks of local hormonal treatment, there were no significant changes in serum levels of luteinizing hormone and estradiol, while sex hormone binding globulins remained low and follicle stimulating hormone levels nearly doubled compared to baseline. Additionally, there were no significant changes in adverse effect rates such as vaginal discharge, facial hair growth, urinary tract or yeast infections, and vaginal or vulvar itching/irritation, except in one trial. The evidence suggests that vaginal estrogen does not lead to systemic absorption of sex hormones, indicating that it may be safe for use in this patient population.
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