Clinical question
How safe and effective is hormone replacement therapy for menopausal symptoms in women surgically treated for epithelial ovarian cancer?
Bottom line
HRT may improve overall survival in wom- en who have undergone surgery for EOC. However, this is based on low‐certainty evidence and, therefore, should be interpreted with caution. We are very uncertain about the impact of HRT on progression‐free survival and incidence of adverse events, such as breast cancer, transient ischaemic accident, cerebrovascular accident and myocardial infarction. Therefore, women and their doctors should make decisions based on individual priorities and symptoms.
Caveat
None of the studies were blinded and 2 studies had high rates of discontinuation of therapy or loss to follow-up. One study was based in Europe and was multicentred, with the remaining 2 from China and South Africa.
Context
Women who have undergone surgical treatment for EOC may develop menopausal symptoms due to immediate loss of ovarian function following surgery and chemotherapy. Women may experience vasomotor symptoms, sleep disturbance, difficulty concentrating, sexual dysfunction, vaginal symptoms and accelerated osteoporosis. Although HRT is the most effective treatment to relieve these symptoms, its safety has been questioned for women with EOC.
Cochrane Systematic Review
Saeaib N et al. Hormone replacement therapy after surgery for epithelial ovarian cancer. Cochrane Database Syst Rev 2020, Issue 1. Art. No.: CD012559. DOI: 10.1002/14651858.CD012559.pub2. This review contains 3 studies involving 370 participants.
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