Vaginal pH-Balanced Gel for the Control of Atrophic Vaginitis Among Breast Cancer Survivors

Lee, Yoo-Kyung; Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh-Hyun; Song, Yong Sang; Kang, Soon Beom

doi:10.1097/aog.0b013e3182118790

Cited by 92 publications

(78 citation statements)

References 20 publications

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“…Vaginal pH-balanced gel improved both vaginal dryness and dyspareunia, lowered vaginal pH and enhanced vaginal maturation index with minimal side effects (mild irritation during the first four weeks of therapy administration) [Lee et al 2011]. These findings suggest that vaginal pH-balanced gel is an alternative option to alleviate vulvovaginal symptoms in symptomatic patients and can ultimately protect against vaginal colonization by nonvaginal microflora, which predispose women to vaginal infections and UTIs.…”

Section: Nonhormonal Treatment Optionsmentioning

confidence: 73%

“…A randomized, double-blinded, placebo-controlled study investigated the effect of a vaginal pH-balanced gel (containing lactic acid) on vaginal symptoms and atrophy in breast cancer survivors [Lee et al 2011]. Vaginal pH-balanced gel improved both vaginal dryness and dyspareunia, lowered vaginal pH and enhanced vaginal maturation index with minimal side effects (mild irritation during the first four weeks of therapy administration) [Lee et al 2011].…”

Section: Nonhormonal Treatment Optionsmentioning

confidence: 99%

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A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy

et al. 2017

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There is increasing attention and concern about managing the adverse effects of adjuvant endocrine therapy for women with early breast cancer as the side effects of therapy influence compliance and can impair quality of life (QoL). Most side effects associated with tamoxifen (TAM) and aromatase inhibitors (AIs) are directly related to estrogen deprivation, and the symptoms are similar to those experienced during natural menopause but appear to be more severe than that seen in the general population. Prolonged estrogen deprivation may lead to atrophy of the vulva, vagina, lower urinary tract and supporting pelvic structures, resulting in a range of genitourinary symptoms that can in turn lead to pain, discomfort, impairment of sexual function and negatively impact on multiple domains of QoL. The genitourinary side effects may be prevented, reduced and managed in most cases but this requires early recognition and appropriate treatment. We provide an overview of practical clinical approaches to understanding the pathophysiology and the management of genitourinary symptoms in postmenopausal women receiving adjuvant endocrine therapy for breast cancer.

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Section: Nonhormonal Treatment Optionsmentioning

confidence: 73%

Section: Nonhormonal Treatment Optionsmentioning

confidence: 99%

A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy

et al. 2017

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“…One small study of 45 patients with breast cancer who experienced vaginal dryness and dyspareunia found that Replens and a placebo preparation were equally effective in relieving symptoms [72]. In a separate randomized, placebocontrolled study that included 86 women, the vaginal pHbalanced gel was more effective in relieving both dryness and dyspareunia [73]. The frequency of use of these vaginal moisturizes is guided by the severity of symptoms, and use can be once every 3 days to daily.…”

Section: Nonendocrine Therapiesmentioning

confidence: 99%

Sexual Health as a Survivorship Issue for Female Cancer Survivors

2014

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As more and more people are successfully treated for and live longer with cancer, greater attention is being directed toward the survivorship needs of this population. Women treated for cancer often experience issues related to sexual health and intimacy, which are frequently cited as areas of concern, even among long-term survivors. Unfortunately, data suggest that providers infrequently discuss these issues. We reviewed a contemporary understanding of sexual health of women and the impact of treatment on both sexual function and intimacy.

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“…Of four studies selected for inclusion criteria [17][18][19][20], one was presented in abstract form [18] and one was a letter [17], and thus limited study information was available. Characteristics of the studies regarding study design and interventions compared, sample size, patient eligibility criteria and patient demographics are described in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

Management of urogenital atrophy in breast cancer patients: a systematic review of available evidence from randomized trials

Mazzarello

Hutton

Ibrahim

et al. 2015

Breast Cancer Res Treat

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Symptoms of urogenital atrophy are common in breast cancer survivors. Its optimal management is currently unknown. A systematic review of randomized controlled trials (RCTs) evaluating treatments for urogenital atrophy in breast cancer patients was performed. EMBASE, Ovid Medline and the Cochrane Library were searched from 1946 to November 2014. Outcomes included improvements in both vaginal symptoms (e.g., dryness, pain, dyspareunia and itching) and vaginal hormone response measured by validated scales [e.g., Vaginal Health Index (VHI) and Vaginal Maturation Index (VMI)]. Of 430 unique citations identified, 4 studies (n = 196) met inclusion criteria. Interventions included pH-balanced gel, Replens(®), lidocaine, Estring(®) and Vagifem(®). Sample sizes ranged from 7 to 98 patients. Given the heterogeneity of the studies, a narrative synthesis of results was performed. One study of 98 patients suggested that vaginal pH-balanced gel (mean VHI 5.00 ± 0.816, mean VMI 51.18 ± 3.753) was more efficient than placebo (VHI 16.98 ± 3.875, p < 0.001, VMI 47.87 ± 2.728, p < 0.001) at 12 weeks in providing vaginal symptom relief. In patients who used lidocaine, 90 % had reduced dyspareunia compared to saline in a study of 46 patients. Although increased serum estradiol occurred, both Estring(®) and Vagifem(®) were shown to improve quality of life and VMI in a study of seven patients. Treatment of urogenital atrophy remains a challenging issue and there is a paucity of RCT evidence addressing this knowledge gap. It is evident that more prospective trials are needed.

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Vaginal pH-Balanced Gel for the Control of Atrophic Vaginitis Among Breast Cancer Survivors

Abstract: I.

Cited by 92 publications

References 20 publications

A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy

A clinical guide to the management of genitourinary symptoms in breast cancer survivors on endocrine therapy

Sexual Health as a Survivorship Issue for Female Cancer Survivors

Management of urogenital atrophy in breast cancer patients: a systematic review of available evidence from randomized trials

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