Treating Bothersome Genitourinary Symptoms in Menopausal Women After Breast Cancer

This transcript has been edited for clarity.

With some 3.8 million US breast cancer survivors, we often see women who have been treated for this common type of cancer and are dealing with vaginal dryness and sexual discomfort caused by genitourinary syndrome of menopause (GSM). Clinicians will find the December 2021 ACOG Clinical Consensus Recommendations to be useful.

Over-the-counter vaginal lubricants, which are used for sexual activity, and moisturizers, which can be used on a regular basis (such as several times weekly), represent first-line treatment for women with symptomatic GSM. Although traditionally, lubricants have been water-based, more recently silicone-based lubricants, which may be more slippery and less irritating, have become widely available. With respect to moisturizers, I have received positive patient feedback regarding Hyalo Gyn, which is applied with an applicator, as well as K-Y Liquibeads, which are applied digitally. These moisturizers may be easier to find online than in pharmacies. I have no disclosures to report regarding these products.

Although the US Food and Drug Administration (FDA) considers use of vaginal estrogen to be contraindicated in women with a personal history of breast cancer, available data have not found an increased recurrence risk among survivors using vaginal estrogen. ACOG's guidance