[Genitourinary menopause syndrome. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]

Long-term efficacy of CO2 fractional laser in the treatment of genitourinary syndrome of menopause

The aim of this study was to evaluate the long-term efficacy and adverse effects of fractionated CO2 laser in the treatment of GSM (Genitourinary Syndrome of menopause). This was a retrospective, monocentric, study conducted between January 2017 and July 2023. Forty-six patients receiving 3 sessions of fractional CO2 laser at 4-6 weeks apart were included. The primary endpoint was the satisfaction of the patient (unsatisfied, neutral or satisfied) 24 months after the treatment. Secondary endpoints were improvement of their GSM, with the use of a sexual health and quality of life scores (FSFI and SF-12), changes in the use of local treatments and adverse events. A sub-group analysis evaluated patients with a history of breast cancer and patient ongoing antihormone therapy. Twenty-four months after treatment, 41 % (n = 19) patients were satisfied, 21 % (n = 10) patients were neutral, and 38 % (n = 17) patients were unsatisfied. There was a significant reduction in hypoesthesia during intercourse (p = 0.007), vaginal discharge (p = 0.009) and vaginal dryness (p = 0.0003). There was no significant improvement in SF-12, FSFI scores or reduction in the use of local treatments. No serious short- or long-term adverse events were reported. Among patients with a history of breast cancer (n = 26), there was a significant reduction in hypoesthesia during intercourse (p = 0016), vaginal discharge (p = 0.041) and vaginal dryness (p = 0.0004). The CO2 fractional laser showed an improvement in GSM 24 months after treatment. In the population of patients followed for breast cancer, results were also promising over the long term of treatment.

Information and oncosexological management in breast cancer patients

OBJECTIVES

Breast cancer treatment is a particularly high-risk situation for the deterioration of sexual health, leading to an alteration in body image and physical deteriorations such as vaginal trophicity. The aim of this study was to evaluate the information received by patients concerning this alteration of their sexual health in relation to their treatment, and to identify their expectations and needs in terms of oncosexual management.

STUDY DESIGN

A bicentric qualitative retrospective study was conducted, involving women aged 18 to 80, treated for breast cancer by total or partial mastectomy after 2014 and having had a follow-up consultation between July and December 2019. Data were collected using medical files and a de-identified questionnaire sent by post or e-mail after obtaining consent. The main outcome measures were the proportion of patients who received informations about oncosexology and those who felt impact on their sexual health.

RESULTS

Of the 274 patients included in the study, 60% said they had received no information about the sexological side effects of their disease or treatment. Of these, 62.5% dared not talk about it during consultation. Patients were keen to receive oncosexological advice or treatment from a specialized nurse or doctor. In 76.1% of cases, patients declared that they had been sexually active in the year prior to their cancer diagnosis, compared with 54.94% after treatment. They reported a loss of femininity in 24% of cases, and 40.5% had no sexual desire.

CONCLUSION

Women treated for breast cancer report a lasting alteration in their body image and sexual activity. Information on the impact of the disease and its treatment on sexual health is inadequate, even though patients are keen to receive specialized care with professional sexology consultations. The impact of breast cancer on sexual health should systematically explained to the patients, especially as treatment options exist and can be offered.

A multicenter, randomized, open, controlled trial to evaluate the efficacy of Honglilai Vaginal Cream and Premarin Vaginal Cream for Genitourinary Syndrome of Menopause in different subgroups of Chinese postmenopausal women

AIM

In a randomized, multicenter, open, controlled trial, we compared the effects of Honglilai Vaginal Cream and Premarin Vaginal Cream in different age subgroups and menopausal year subgroups (trial registration numbers: 02003L00493).

METHODS

Postmenopausal women with Genitourinary Syndrome of Menopause (GSM) were divided into Honglilai group (n = 319) and Premarin group (n = 116), while subgroups were divided according to their different characteristics of age and menopausal years. Honglilai Vaginal Cream (0.625 mg/g) or Premarin Vaginal Cream (0.625 mg/g) once daily for 3 weeks.

RESULTS

In the subgroup of participates >60 years, there were no significant differences of Vaginal Cell Maturation Index (VMI) between the two groups after treatment (p = .171). In the subgroup of 50-59 years, the VMI of Honglilai group was significantly lower than Premarin group (Honglilai group: 74.37 ± 22.76; Premarin group: 80.06 ± 16.15; p = .02). There were no significant differences of Vaginal symptom scores between Honglilai group and Premarin group in every sub-group (p > .05).

CONCLUSIONS

Honglilai Vaginal Cream had comparable efficacy with Premarin Vaginal Cream in Chinese women older than 60 years.