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Di Stanislao M, Coada CA, De Terlizzi F, Di Costanzo S, Fiuzzi E, Mezzapesa F, Dondi G, Paoli D, Damiani GR, Raspagliesi F, Bogani G, Ditto A, Morganti AG, De Iaco P, Perrone AM. Laser Therapy in Heavily Treated Oncological Patients Improves Vaginal Health Parameters. Cancers (Basel) 2024; 16:2722. [PMID: 39123449 PMCID: PMC11311561 DOI: 10.3390/cancers16152722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
This study aimed to investigate the efficacy and duration of multiple non-ablative intravaginal CO2 laser (V-lase®) cycles in breast cancer patients, gynecological and other pelvic cancers previously subjected to multiple oncological treatments. This prospective study enrolled women under the age of 65 years who reported vaginal symptoms. Data on the Vaginal Health Index (VHI), vaginal length (VL), vaginal pain measured using a Visual Analog Scale (VAS), and the Female Sexual Function Index (FSFI) were collected at baseline and before each laser application, and at subsequent follow-up visits. A total of 170 laser applications were performed on 113 women with various types of cancer. Most patients (57.5%) had received radiotherapy-based treatments before receiving laser treatment. Vaginal health parameters and sexual function improved significantly with each laser application. However, a temporary decline in these improvements occurred during the intervals between cycles. Such worsening was reversed with the subsequent cycle in all groups of patients, irrespective of the type of oncological treatments they had undergone. Multiple course vaginal laser therapy showed promising results as a potential treatment for vaginal atrophy in heavily treated gynecological and breast cancer patients, necessitating further research to determine the optimal time interval between cycles to ensure sustained positive effects.
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Affiliation(s)
- Marco Di Stanislao
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Camelia Alexandra Coada
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | | | - Stella Di Costanzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Enrico Fiuzzi
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Francesco Mezzapesa
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Giulia Dondi
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
| | - Damiano Paoli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | | | - Francesco Raspagliesi
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (F.R.); (G.B.); (A.D.)
| | - Giorgio Bogani
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (F.R.); (G.B.); (A.D.)
| | - Antonino Ditto
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (F.R.); (G.B.); (A.D.)
| | | | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
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Jankovic S, Rovcanin M, Zamurovic M, Jovanovic B, Raicevic T, Tomic A. Multifaceted Impact of CO 2 Laser Therapy on Genitourinary Syndrome of Menopause, Vulvovaginal Atrophy and Sexual Function. Healthcare (Basel) 2024; 12:1385. [PMID: 39057528 PMCID: PMC11275429 DOI: 10.3390/healthcare12141385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder-urethral regions related to menopause changes, negatively influencing woman's quality of life and sexual activity. Fractional micro-ablative CO2 laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO2 laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO2 laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women.
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Affiliation(s)
- Svetlana Jankovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Marija Rovcanin
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Milena Zamurovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Branka Jovanovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Tatjana Raicevic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Ana Tomic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Jankovic S, Rovcanin M, Tomic A, Jurisic A, Milovanovic Z, Zamurovic M. Understanding the Benefits of CO 2 Laser Treatment for Vulvovaginal Atrophy. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1059. [PMID: 39064488 PMCID: PMC11279000 DOI: 10.3390/medicina60071059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Postmenopausal vaginal discomfort is often attributed to vulvovaginal atrophy (VVA). Women with VVA experience symptoms such as vaginal dryness, itching, burning, irritation, and dyspareunia. Materials and Methods: This pilot study was conducted to assess the effects of a micro-ablative fractional CO2 laser on the clinical symptoms of VVA, as well as concordant sexual function. The severity of VVA symptoms was evaluated by a visual analogue scale (VAS), while the condition of the vaginal mucosa was evaluated using the Vaginal Health Index Score (VHSI). Sexual function was evaluated using the Female Sexual Function Index (FSFI) Questionnaire. Results: Our cohort included 84 sexually active postmenopausal women with bothersome VVA, leading to sexual health complaints. The mean age of the participants in our study was 55.2 ± 5.4 years, with an average postmenopausal period of 6 ± 4.8 years. The age of our patients and the length of their postmenopausal period exhibited a significant negative correlation with VHSI scores, while a longer postmenopausal period was associated with increased severity of vaginal dryness and dyspareunia. Baseline VHSI values showed that 65% of patients had atrophic vaginitis with pronounced VVA symptoms (70.2% experienced vaginal itching, 73.8% reported vaginal burning, 95.3% had vaginal dryness, and 86.1% suffered from dyspareunia). Lower VHSI values significantly correlated with lower FSFI scores, while more severe VVA symptoms scores correlated with lower FSFI scores. VVA symptoms were significantly less severe after treatment. VHIS regained high non-atrophic values in 98.8% of patients post-treatment (p < 0.001). FSFI total and domain scores were significantly higher after treatment (p < 0.001). Conclusions: Our study revealed that fractional CO2 laser is a useful treatment option to alleviate VVA symptoms and improve vaginal health and sexual functioning in postmenopausal women.
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Affiliation(s)
- Svetlana Jankovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia; (M.R.); (A.J.); (Z.M.); (M.Z.)
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Marija Rovcanin
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia; (M.R.); (A.J.); (Z.M.); (M.Z.)
| | - Ana Tomic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia;
| | - Aleksandar Jurisic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia; (M.R.); (A.J.); (Z.M.); (M.Z.)
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Zagorka Milovanovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia; (M.R.); (A.J.); (Z.M.); (M.Z.)
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Milena Zamurovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia; (M.R.); (A.J.); (Z.M.); (M.Z.)
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
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Lami A, Alvisi S, Baldassarre M, Zanella S, Amati V, Seracchioli R, Meriggiola MC. Safety and efficacy of non-ablative CO 2 laser treatment of vulvo-vaginal atrophy in women with history of breast cancer. Arch Gynecol Obstet 2024; 309:1575-1583. [PMID: 38253692 DOI: 10.1007/s00404-023-07323-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/27/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE Breast cancer survivors (BCS) suffer severe vulvo-vaginal atrophy (VVA) and some of the most effective therapies are contraindicated. In literature we have no data about the non-ablative CO2 laser on these women. The aim of this study was to examine its efficacy, safety and acceptability in BCS. MATERIALS AND METHODS The enrolled women underwent 3 sessions of laser therapy (t0, t1, t2) and a one-month follow up examination (t3). At each time point we measured objective signs of VVA via VHI (Vaginal Health Index) and VuHI (Vulvar Health Index) and subjective parameters (Dryness, Burning, Itching, Dysuria) via visual analog scales (VAS). In sexually active women we evaluated the sexual function with FSFI (Female Sexual Function Index), FSDS (Female Sexual Distress Score) scores and MENQOL (menopause quality of life questionnaire). RESULTS We enrolled 26 BCS. The mean VHI, VuVHI, dryness and burning VAS scores improved significantly and this improvement was not influenced by the initial VVA grade. MENQOL sexual domain, Lubrication, Orgasm and Pain domains and FSFI total score improved significantly, while Desire, Arousal and Satisfaction domains of FSFI and FSDS did not. At t0 women using Aromatase Inhibitors suffered more severe vaginal dryness than women using Tamoxifen or no therapy, but the three subgroups improved without differences. No adverse event and minimum discomfort were reported. CONCLUSIONS The non-ablative CO2 laser is a safe and effective treatment of VVA and has positive effects on sexual function in BCS regardless the use of adjuvant therapies and the initial grade of VVA.
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Affiliation(s)
- Alessandra Lami
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Stefania Alvisi
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maurizio Baldassarre
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy
| | - Sara Zanella
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Veronica Amati
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Renato Seracchioli
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maria Cristina Meriggiola
- Gynecology and Physiopathology of Human Reproduction, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Via Massarenti 13, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Center for Applied Biomedical Research (CRBA), University of Bologna, Bologna, Italy
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Pinho SC, Heinke T, Dutra PFSP, Carmo A, Salmeron C, Karoleski L, Focchi G, Speck NMG, Pennati BM, Silva I. Efficacy of Fractional Laser on Steroid Receptors in GSM Patients. Bioengineering (Basel) 2023; 10:1087. [PMID: 37760189 PMCID: PMC10525165 DOI: 10.3390/bioengineering10091087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND To compare the efficacy of CO2 fractional laser with that of topical estriol for treating genitourinary syndrome of menopause and to investigate the relationship between epithelial thickness and vaginal atrophy. METHODS Twenty-five menopausal women were randomized to receive either laser or estrogen treatment. Vaginal biopsies before and after treatment were compared to assess the amount and distribution of estrogen and progesterone receptors. RESULTS Estrogen receptor levels were statistically similar between groups before and after treatment. Although there was no change over time in the estrogen group, an increase in receptor levels was confirmed in the laser group. Changes in estrogen receptor levels showed no association with treatment. Progesterone receptor levels were statistically similar between groups throughout treatment. There was no change over time in both groups. These changes displayed no association with the type of treatment. There was no significant correlation between epithelium thickness and estrogen or progesterone receptor levels. CONCLUSIONS Estrogen and progesterone receptor levels increased and were maintained, respectively, in the vaginal epithelium in both groups. There was no significant relationship between epithelium thickness and receptor density. Laser therapy had similar outcomes to the gold standard without involving the disadvantages of hormone therapy.
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Affiliation(s)
- Stella Catunda Pinho
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Thais Heinke
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Paula Fernanda Santos Pallone Dutra
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Andreia Carmo
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Camilla Salmeron
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Luciana Karoleski
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Gustavo Focchi
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | - Neila Maria Góis Speck
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
| | | | - Ivaldo Silva
- Department of Gynecology, Paulista Medical School, Federal University of Sao Paulo, UNIFESP/EPM, Sao Paulo 04021-001, Brazil; (S.C.P.); (T.H.); (P.F.S.P.D.); (A.C.); (C.S.); (L.K.); (G.F.); (N.M.G.S.); (I.S.)
- Department of Education, ICT and Learning, Østfold University College, 1757 Halden, Norway
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Albalawi NS, Almohammadi MA, Albalawi AR. Comparison of the Efficacy of Vaginal Hyaluronic Acid to Estrogen for the Treatment of Vaginal Atrophy in Postmenopausal Women: A Systematic Review. Cureus 2023; 15:e44191. [PMID: 37767255 PMCID: PMC10520994 DOI: 10.7759/cureus.44191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Topical estrogen is effective for treating postmenopausal vaginal atrophy. However, there is a potential risk of estrogen-related adverse effects. There is a need for finding effective non-hormonal treatment for vaginal atrophy. The topical application of moisturising agents, such as hyaluronic acid (HA), represents a promising non-hormonal treatment for the relief of vaginal atrophy. This study aimed to summarize the evidence regarding the efficacy of topical HA compared to topical estrogen in postmenopausal women with vaginal atrophy. The literature search covered English-published studies from database inception till February 2023. The search included the electronic databases of MEDLINE/PubMed, Cochrane Library, Web of Science, ProQuest, and Scopus, using the terms "Hyaluronic Acid" AND "Postmenopause" AND "Vagina" AND "Atrophy". Due to the diversity in reporting outcomes, meta-analysis was not feasible. A narrative synthesis with a systematic approach was conducted by vote counting of studies that included a direct comparison between topical HA and topical estrogen. Six studies were included. Intra-group comparisons showed that both interventions were significantly effective in alleviating the symptoms of vaginal atrophy and dyspareunia as well as improving vaginal pH and cell maturation index. However, inter-group comparisons in most studies showed that estrogen was superior to HA in relieving vaginal symptoms and improving vaginal pH, dyspareunia, and the cell maturation index. There is no evidence to show the superiority of HA to estrogen in the treatment of postmenopausal vaginal atrophy. However, the therapeutic efficacy of HA seems to be comparable to estrogen and considering its safety, HA can be used as an alternative to estrogen in patients who do not want to use estrogen. The available studies have several limitations, and the reporting of outcomes was considerably heterogeneous.
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Affiliation(s)
- Nada Saleh Albalawi
- Geriatrics Department, King Fahad Specialist Hospital, Ministry of Health, Tabuk, SAU
| | - Maram Ati Almohammadi
- Training Department, Academic Affairs and Training Administration, Ministry of Health, Tabuk, SAU
| | - Ahmad Raja Albalawi
- Diabetic and Endocrine Department, King Fahad Specialist Hospital, Ministry of Health, Tabuk, SAU
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Sexuality after breast cancer, how to provide a global and contemporary approach. Bull Cancer 2023; 110:113-128. [PMID: 36336478 DOI: 10.1016/j.bulcan.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Patients' sexuality is one of the major and most neglected impact of breast cancer (BC) and its treatment. Even though research is ongoing on the subject, sexuality issues are rarely taken into account and efficiently dealt with in clinical practice. The objective is to review the impact of BC and its treatment on modern women sexuality. In the literature, a heterogeneous level of advancement is notable in the different publishing countries depending on the cultural background; some countries simply do not publish on the matter, others mainly discuss the male partners and practicians experience, and lastly, the most progressive countries have moved up to studying niches of patients such as sexual and gender minorities. A multidisciplinary approach, including pharmacologic and nonpharmacologic management, appears most efficient. There is a need for greater inclusion of partners and for providing a specific training to first-line health care providers. This review provides a general contemporary worldwide overview of the state of the art in sexuality issues in BC patients and survivors.
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