Genitourinary symptoms in women with breast cancer: frequency, severity and impact

To improve understanding of genitourinary symptoms (GUS) in women with breast cancer (BC).

Women with BC completed a survey assessing the type, severity, and impact of GUS experienced, and perceptions of treatment options.

Surveys were completed by 506 women: median age 60 years (range 30 - 83). The majority reported: being sexually active (52%); currently taking endocrine therapy (58%); and having early-stage BC (84%). 69% had GUS, with some changing (5%) or stopping (4%) endocrine therapy as a result. Vaginal dryness was the most common symptom (62%), followed by pain during penetration (41%) and itch (33%). Only 44% recalled being warned by their cancer doctor that BC treatment can cause GUS, and 38% reported never being asked about GUS. Being uncomfortable talking to a male healthcare professional was a moderate or major barrier to accessing advice and treatment for GUS in 28% of respondents. A minority reported using vaginal: lubricants (40%); moisturisers (25%); or oestrogens (16%). Amongst those using vaginal oestrogens, 45% found they helped "quite a bit" or "very much". The most frequently reported moderate to major barrier to using vaginal oestrogens was product information warning against use in women with BC.

Although GUS are very common in women with BC, the majority of women in our study do not recall being warned or asked about these symptoms. Healthcare professionals should initiate conversations about GUS and treatment options with women with BC to help reduce the impact of these symptoms.