Those patients with histology-dependent breast cancer with hormonal factor, are subsidiaries of anti-estrogen treatment. To date, there are different drugs which, due to their composition, can affect to a greater or lesser degree, causing side effects on the genital apparatus.
Antiestrogens: tamoxifen and aromatase
In this regard, tamoxifen is a treatment of choice. However, there are others that are beginning to replace it, such as aromatase derivatives, whose purpose is to avoid relapses or to increase the percentage of cure.
This is an excellent drug, but it is not free of possible side effects which, although they do not condition a change of drug, require monitoring.
If we place the positive and negative effects on the balance, there is no doubt that it is in favor of taking the drug. Even so, it is true that, in symbiosis with the oncologist, in breast units, it is advisable to carry out gynecological check-ups every 6 months, and then move on to one year.
Side effects of these drugs
With this preamble, what moves us to comment on the subject is the evidence that this treatment intensifies the discomfort generated by the lack of estrogen by acting on these receptors and having anti-estrogenic capacity.
Both in young patients and menopausal patients who have been treated and their periods have been cancelled, they begin to notice discomfort such as the following: vulvovaginal dryness, itching and dyspareunia.
Solution to the discomfort
The treatment for this type of discomfort is local, using non-hormonal moisturizing creams, but this is not a short or long term solution. Moisturizing cream only manages the most immediate discomfort, but does not activate the vulvovaginal tissue. Even so, it should not be rejected in any case.
There are some other treatments that target estrogen receptors at the vaginal level which, apparently, have less impact on the side effects of increased risk of endometrial cancer. However, if we know that the CO2 laser is more optimal and has fewer risks, it is a good contribution to the vaginal quality of the patient, also facilitating sexual relations which, given the vaginal atrophy, are basically deteriorated.
By indicating the vulvovaginal CO2 laser, adding hyaluronic acid cream, we obtain very satisfactory percentage results, without producing side effects and absolute tolerance.
How long should it be applied?
There is no specific limit, since the laser can be applied indefinitely, depending on the response. The number of sessions can be performed at intervals of 6 months to 1 or 2 years, with hyaluronic cream every night.
In any case, it is a technique indicated for this problem, with very positive results: it is not harmful, it revitalizes the tissue, lubricates it and produces well-being.
Treatment with tamoxifen and additional alterations
These drugs have an effect on the endometrium, producing a proliferation of the endometrium and giving a pattern that we call TMF pattern, which consists of an increase in the glandular cysticopolypoid endometrium, in addition to being able to increase the size of myomas. In this sense, it is important to mention the control and ultrasound diagnosis and, basically, hysteroscopic diagnosis on occasions, if bleeding occurs.