Short-term exposure to low-dose vaginal estrogen therapy may relieve some symptoms of menopause for younger survivors of endometrial cancer without increasing the risk of endometrial cancer recurrence, according to findings from a study published in Menopause.
“Early detection and improved, targeted therapies have led to more women surviving their endometrial cancer diagnoses. However, the sequalae from these life-sparing treatments often result in significant impairment to quality of life and sexual function. Genitourinary symptoms associated with menopause rarely improve without treatment and are exacerbated in the context of abrupt, early menopause. Helping survivors of endometrial cancer to make evidence-based decisions about their care is empowering, especially during a vulnerable time. Expanding treatment options to include local, low-dose vaginal estrogen therapy in this population will have long-lasting benefits,” stated Monica Christmas, MD, Associate Medical Director for The Menopause Society.
Background
Previously hormone therapies had black-boxed warnings related to risks for severe, potential adverse effects, regardless of the strength of the therapy. As a result, many women with endometrial cancer who prescribed non-hormone therapies for their menopause symptoms with limited efficacy.
Recently, however, the U.S. Food and Drug Administration approved changes to the drug labels for six menopausal hormone therapies to remove risk statements related to cardiovascular disease, breast cancer, and probable dementia.
Study Methods
Researchers conducted a cohort study analyzing women between the ages of 18 and 51 years who were diagnosed with endometrial cancer between November 2005 and December 2023. Patient data was collected from the US Collaborative Network from the TriNetX database.
With 1:1 propensity score matching, they created cohorts of patients who did and did not receive vaginal estrogen therapy in the year following their endometrial cancer diagnosis. The researchers analyzed patient outcomes and risks, focusing especially on the chance of endometrial cancer recurrence.
Key Findings
A total of 1,412 survivors of endometrial cancer had received vaginal estrogen therapy and 23,859 women did not receive hormone therapy, which was narrowed down to 1,412 in the control group due to the propensity score matching. An estimated 5.6% of young survivors of endometrial cancer were started on vaginal estrogen therapy.
The women were treated with vaginal estrogen therapy for an average of 1.88 years (standard deviation, 0.36 years).
The risk for endometrial cancer recurrence was not increased with vaginal estrogen therapy use (hazard ratio = 0.87, 95% confidence interval = 0.60–1.27).
DISCLOSURE: For full disclosures of the study authors, visit journals.lww.com.
