Management of postmenopausal symptoms in breast cancer survivors

With the increasing numbers of breast cancers survivors, menopause, its symptoms, and its physical complications are becoming more prevalent problems in this patient population. Hormonal replacement, which has been the cornerstone therapy of menopausal related symptoms for decades, recently has been shown to increase breast cancer incidence as well as risk of recurrence and no longer should be recommended. Menopausal symptoms and complications such as hot flashes, vaginal dryness, dyspareunia, and osteoporosis leading to fractures have a negative impact on the quality of life of both breast cancer survivors and the general postmenopausal population. The purpose of this review is to discuss the evidence for the use of alternative therapies for menopausal symptoms, thus providing guidance and recommendations that should facilitate therapeutic decisions in the daily practice of medical oncologists and primary care physicians.