With an estimated 3.8 million breast cancer survivors in the United States, obstetrician-gynecologists often are on the front lines of addressing survivorship issues, including the hypoestrogenic-related adverse effects of cancer therapies or early menopause in survivors (1). Although systemic and vaginal estrogen are used widely for symptomatic relief of genitourinary syndrome of menopause in the general population, among individuals with a history of hormone-sensitive cancer, there is uncertainty about the safety of hormone-based therapy, leading many individuals with bothersome symptoms to remain untreated, with potential negative consequences on quality of life (2). An effective management strategy requires familiarity with a range of both hormonal and nonhormonal treatment options, knowledge about the pharmaceutical mechanisms of action, and the ability to tailor treatment based on individual risk factors. This clinical consensus document was developed using an a priori protocol in conjunction with two authors specializing in urogynecology and gynecologic oncology. This document has been updated to review the safety and efficacy of newer hormonal treatment options as well as nonhormonal modalities.

中文翻译：

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有雌激素依赖性乳腺癌病史的个体泌尿生殖系统症状的治疗：临床共识。

据估计，美国有 380 万乳腺癌幸存者，妇产科医生经常站在解决生存问题的第一线，包括癌症治疗的低雌激素相关不良反应或幸存者过早绝经 (1)。尽管全身雌激素和阴道雌激素广泛用于缓解一般人群中更年期泌尿生殖综合征的症状，但在有激素敏感性癌症病史的个体中，基于激素的治疗​​的安全性存在不确定性，导致许多个体出现令人烦恼的症状不接受治疗，可能对生活质量产生负面影响 (2)。有效的管理策略需要熟悉一系列激素和非激素治疗方案，了解药物作用机制，以及根据个人风险因素定制治疗的能力。该临床共识文件是与两位专门从事泌尿妇科和妇科肿瘤学的作者一起使用先验方案制定的。本文件已更新，以审查新的激素治疗方案以及非激素治疗方式的安全性和有效性。