EMAS and IGCS position statement on managing menopausal symptoms after gynecological cancer

  • Maturitas

  • Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • The European Menopause and Andropause Society (EMAS) and the International Gynecologic Cancer Society (IGCS) have released a position statement on managing menopausal symptoms after gynecological cancer.

Why this matters

  • 1.3 million new gynecological cancers are diagnosed worldwide each year.
  • Gynecological cancer treatment can result in surgical menopause even as hormone receptors are intact and with use of antiestrogenic therapies.

Key results

  • Management by tumor type:
    • Endometrial cancer: women with low-grade, early-stage endometrial cancer may consider topical or systemic estrogens.
    • Uterine sarcoma: if hormonal dependent, avoid hormone replacement therapy (HRT).
    • Ovarian, fallopian tube, and stromal cancer: limited evidence that HRT does not appear to cause harm with nonserous epithelial ovarian cancer and germ cell tumors; use caution with serous and granulosa cell tumors.
    • Cervical, vaginal, and vulvar cancer: HRT is not contraindicated.

Study design

  • Systematic review and position statement from EMAS and IGCS.
  • Funding: None.

Limitations

  • Limitations related to the limitations of original studies.
  • Paucity of data for some cases makes recommendations difficult.