Hormonal Management of Menopausal Symptoms in Women With a History of Gynecologic Malignancy

Benjamin S. Harris, MD, MPH; Katherine C. Bishop, MD; Jeffrey A. Kuller, MD; Anne C. Ford, MD; Lisa C. Muasher, MD, MPH; Sarah E. Cantrell, MLIS; Thomas M. Price, MD

Disclosures

Menopause. 2020;27(2):243-248. 

In This Article

Cervical Cancer

There are approximately 13,000 new diagnoses of cervical cancer annually.[50] Although fertility-sparing surgery is an option for early stage disease, standard treatment involves either radical hysterectomy (±bilateral salpingo-oophorectomy) or primary chemoradiotherapy. Both treatments can result in premature ovarian insufficiency, highlighting the importance of HT in this patient population.

In a prospective cohort study by Ploch[51] there was no difference in progression-free or overall survival among women with a history of early stage squamous cell carcinoma of the cervix who received HT. Interestingly, a multicenter case-control study by Lacey et al[52] found an association between ever use of HT and the development of adenocarcinomas of the cervix (OR 2.1, 95% CI 0.95–4.6), but not squamous cell carcinomas of the cervix (OR 0.85, 95% CI 0.34–2.1). Given that approximately 15% of cervical cancers are adenocarcinomas, HT is not appropriate for patients with adenocarcinoma of the cervix given the histologic subtype may be responsive to estrogen.[53]

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