Safety of hormone replacement therapy following risk-reducing salpingo-oophorectomy: systematic review of literature and guidelines

Vermeulen, R F M; Korse, Catharina M.; Kenter, Gemma G.; Zanten, Monique M.A. Brood-van; Beurden, Marc van

doi:10.1080/13697137.2019.1582622

Cited by 34 publications

(23 citation statements)

References 46 publications

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“…However, this will lead to early/premature menopause. Data on menopausal hormone therapy after prophylactic oophorectomy are sparse, but short-term use seems to be safe 58…”

Section: Introductionmentioning

confidence: 99%

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

Rees

Angioli

Coleman

et al. 2020

Int J Gynecol Cancer

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Worldwide, it is estimated that about 1.3 million new gynecological cancer cases are diagnosed each year. For 2018, the predicted annual totals were cervix uteri 569 847, corpus uteri 382 069, ovary 295 414, vulva 44 235, and vagina 17 600. Treatments include hysterectomy with or without bilateral salpingo-oophorectomy, radiotherapy, and chemotherapy. These can result in loss of ovarian function and, in women under the age of 45 years, early menopause. The aim of this position statement is to set out an individualized approach to the management, with or without menopausal hormone therapy, of menopausal symptoms and the prevention and treatment of osteoporosis in women with gynecological cancer. Our methods comprised a literature review and consensus of expert opinion. The limited data suggest that women with low-grade, early-stage endometrial cancer may consider systemic or topical estrogens. However, menopausal hormone therapy may stimulate tumor growth in patients with more advanced disease, and non-hormonal approaches are recommended. Uterine sarcomas may be hormone dependent, and therefore estrogen and progesterone receptor testing should be undertaken to guide decisions as to whether menopausal hormone therapy or non-hormonal strategies should be used. The limited evidence available suggests that menopausal hormone therapy, either systemic or topical, does not appear to be associated with harm and does not decrease overall or disease-free survival in women with non-serous epithelial ovarian cancer and germ cell tumors. Caution is required with both systemic and topical menopausal hormone therapy in women with serous and granulosa cell tumors because of their hormone dependence, and non-hormonal options are recommended as initial therapy. There is no evidence to contraindicate the use of systemic or topical menopausal hormone therapy by women with cervical, vaginal, or vulvar cancer, as these tumors are not considered to be hormone dependent.

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“…However, this will lead to early/premature menopause. Data on menopausal hormone therapy after prophylactic oophorectomy are sparse, but short-term use seems to be safe 58…”

Section: Introductionmentioning

confidence: 99%

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

Rees

Angioli

Coleman

et al. 2020

Int J Gynecol Cancer

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“…In general, most of the reviewers conclude, that there is no evidence for an increase in breast cancer risk in BRCA1/2 mutation carriers after RRBSO, but that more data are needed to draw clear conclusions. Vermeulen et al especially point out the possible adverse effect of progestin-containing HRT found by Kotsopoulos et al and the need of further investigation in this direction (Kotsopoulos et al 2018 ; Vermeulen et al 2019 ). In contrast, the recently published review by Gaba et al did not find a change in clinical practice justifiable based on this study due to small numbers and inconsistent follow-up (Gaba and Manchanda 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the safety of endocrine interventions in BRCA1/2 mutation carriers has gradually gained attention. A number of systematic reviews addressing breast cancer risk associated with HRT following RRBSO in BRCA1/2 mutation carriers have been published (Siyam et al 2017 ; Birrer et al 2018 ; Gordhandas et al 2019 ; Vermeulen et al 2019 ; Gaba and Manchanda 2020 ). According to one of those reviews, the safety of HRT is demonstrated best in the PROSE study by Rebbeck in 2005 (Birrer et al 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Hormone replacement therapy in BRCA mutation carriers and risk of ovarian, endometrial, and breast cancer: a systematic review

Huber

Seitz

Kast

et al. 2021

J Cancer Res Clin Oncol

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Purpose BRCA mutation carriers have an increased risk of developing breast or ovarian cancer. Risk-reducing bilateral salpingo-oophorectomy (RRBSO) is associated with a decrease in risk for tubal and ovarian cancer. Hormone replacement therapy (HRT) may increase breast, ovarian, and endometrial cancer risk in the general population. This review analyses the published data on HRT and risk of cancer in BRCA mutation carriers with and without RRBSO. Methods We included all relevant articles published in English from 1995 to October 2020. Sources were identified through a search on PubMed and Cochrane Library. Results We included one case–control and one retrospective cohort study on ovarian and one case–control study on endometrial cancer risk and HRT in BRCA mutation carriers. Regarding breast cancer risk, one case–control study on BRCA mutation carriers with and without RRBSO and one case–control study, one Markov chain decision model, two prospective cohort studies, and one metaanalysis on carriers after RRBSO were included. For ovarian cancer, results were ambiguous. For breast cancer, most studies did not find an adverse effect associated with HRT. However, some of the studies found a risk modification associated with different formulations and duration of use. Conclusion Although data are limited, HRT does not seem to have a relevant effect on cancer risk in BRCA mutation carriers. RRBSO should not be postponed to avoid subsequent HRT in this population. Adequate HRT after RRBSO should be offered to avoid chronic diseases resulting from low estrogen levels. However, further data on the safety of different formulations are needed.

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“…Later, these cryopreserved gametes may be used through ART. Hormonal therapy is effective in certain cases of infertility such as defective ovulation and low sperm count; however, it is associated with other health concerns such as breast cancer [ 8 , 9 ]. Recent data indicate that ART can resolve almost 80% of infertility issues [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Stem Cells and Their Derived Extracellular Vesicles in Restoring Female and Male Fertility

Qamar

Hussain

Rafique

et al. 2021

Cells

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Infertility is a globally recognized issue caused by different reproductive disorders. To date, various therapeutic approaches to restore fertility have been attempted including etiology-specific medication, hormonal therapies, surgical excisions, and assisted reproductive technologies. Although these approaches produce results, however, fertility restoration is not achieved in all cases. Advances in using stem cell (SC) therapy hold a great promise for treating infertile patients due to their abilities to self-renew, differentiate, and produce different paracrine factors to regenerate the damaged or injured cells and replenish the affected germ cells. Furthermore, SCs secrete extracellular vesicles (EVs) containing biologically active molecules including nucleic acids, lipids, and proteins. EVs are involved in various physiological and pathological processes and show promising non-cellular therapeutic uses to combat infertility. Several studies have indicated that SCs and/or their derived EVs transplantation plays a crucial role in the regeneration of different segments of the reproductive system, oocyte production, and initiation of sperm production. However, available evidence triggers the need to testify the efficacy of SC transplantation or EVs injection in resolving the infertility issues of the human population. In this review, we highlight the recent literature covering the issues of infertility in females and males, with a special focus on the possible treatments by stem cells or their derived EVs.

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Safety of hormone replacement therapy following risk-reducing salpingo-oophorectomy: systematic review of literature and guidelines

Cited by 34 publications

References 46 publications

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

Hormone replacement therapy in BRCA mutation carriers and risk of ovarian, endometrial, and breast cancer: a systematic review

The Role of Stem Cells and Their Derived Extracellular Vesicles in Restoring Female and Male Fertility

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