[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-370364-105":59,"doc-detail-370364-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","updates-in-hormone-replacement-therapy-for-survivors-of-gynecologic-cancers-opinion-statement","Updates in Hormone Replacement Therapy for Survivors of Gynecologic Cancers - Opinion Statement","","Opinion statement focused on hormone replacement therapy (HRT) for survivors of selected gynecologic cancers, including early-stage, low-grade endometrial cancers; epithelial and germ cell ovarian cancers; and early-stage squamous cell cervical, vulvar, and vaginal cancers, as well as patients undergoing risk-reducing surgery for BRCA or Lynch mutations. Treatment initiation is recommended ideally before age 60 or within ten years of menopause, based on individualized risk-benefit discussions. Evidence highlights low-dose vaginal estrogen for vulvovaginal symptoms or low-dose systemic estrogen for vasomotor symptoms combined with progesterone when the uterus is intact. Nonhormonal options are also considered when appropriate.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/updates-in-hormone-replacement-therapy-for-survivors-of-gynecologic-cancers-opinion-statement/370364/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/updates-in-hormone-replacement-therapy-for-survivors-of-gynecologic-cancers-opinion-statement/370364.png","ImageObject",300,407,{"name":92,"@type":93},"Riley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Which gynecologic cancer survivors may safely use hormone replacement therapy (HRT)?","Question",{"text":112,"@type":113},"Survivors of early-stage, low-grade endometrial cancers; epithelial and germ cell ovarian cancers; and early-stage squamous cell cervical, vulvar, and vaginal cancers may use HRT. Patients who have undergone risk-reducing surgery for BRCA or Lynch syndrome mutations are also included.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"When is HRT ideally initiated after menopause for eligible patients?",{"text":117,"@type":113},"HRT is ideally initiated in patients younger than age 60 or within ten years of menopause, after individualized discussion of risks, benefits, and symptom severity.",{"name":119,"@type":110,"acceptedAnswer":120},"What are the recommended hormone regimens for different menopausal symptoms in this population?",{"text":121,"@type":113},"Low-dose vaginal estrogen is highlighted for vulvovaginal symptoms, while low-dose systemic estrogen is highlighted for vasomotor symptoms. Progesterone should be combined when the uterus is intact.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},370364,1790307323,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","Current Treatment Options in Oncology (2025) 26:179–186  \n[https://doi.org/10.1007/s1](https://doi.org/10.1007/s1) 1864-025-01298-5  \nUpdates in Hormone Replacement Therapy for Survivors of Gynecologic Cancers  \nMegan Gorman1 · Karin Shih1  \nAccepted: 3 February 2025 / Published online: 5 March 2025 © The Author(s) 2025  \nOpinion Statement  \nSymptoms of menopause and the sequelae of gynecologic cancer treatment can be severe in their physical and mental impact on patient quality of life. Survivors of certain gynecologic cancers – namely, early-stage, low-grade endometrial cancers; epithelial and germ cell ovarian cancers; and early-stage squamous cell cervical, vulvar, and vaginal cancers – as well as those who have undergone risk-reducing surgery for BRCA or Lynch syndrome mutations may safely use hormone replacement therapy (HRT). Treatment is ideally initiated in patients younger than age 60 or within ten years of menopause. The decision to start treatment should be made on an individualized basis after discussion of risks, benefits, and symptom severity with patients. Data suggest that the safest HRT regimens in this population include low-dose vaginal estrogen for the treatment of vulvovaginal symptoms, or low-dose systemic estrogen for the treatment of vasomotor symptoms, combined with progesterone in patients with an intact uterus. Therapies such as SSRIs/SNRIs, vaginal moisturizers, pelvic floor physical therapy, and psychosocial counseling should also be considered when appropriate for their effectiveness in managing menopausal symptoms without the potential risk of hormones.  \nKeywords Uterine cancer · Ovarian cancer · Cervical cancer · Hormone replacement therapy · Menopause  \nIntroduction  \nMenopause and Hormone Replacement Therapy  \nMenopause is defined as the cessation of menstruation after either the natural or surgical loss of ovarian function. Natural menopause is determined retrospectively after a woman has experienced amenorrhea for 12 months. The average age of menopause in the US is 51 years old, though the perimenopausal period and its associated symptoms begins years before the last menstrual period [1] .  \nPre-or perimenopausal patients undergoing treatment for gynecologic cancers will often undergo induced menopause secondary to cancer treatment. Induced menopause is the cessation of menstruation and ovarian function due to surgical removal of the ovaries, or damage to the ovaries  \n* Karin Shih[kshih1@northwell.edu](kshih1@northwell.edu)  \n1 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, New Hyde Park, NY 11040, USA  \nfrom radiation or medical treatment. Approximately 40% of patients who are diagnosed with gynecologic malignancies are pre-or perimenopausal at the time of their diagnosis [2] .  \nSymptoms of decreased estrogen and progesterone include vasomotor symptoms, mood changes, and vulvovaginal atrophy, though not all patients seek treatment. The symptoms of treatment-induced menopause may be more severe given their more sudden onset, and can have a more negative impact on quality of life.  \nVasomotor symptoms, affecting approximately 80% of menopausal women, are characterized by episodes of flushing, redness, perspiration, and chills, often accompanied by anxiety or sleep disturbances. These symptoms are best treated with systemic estrogen alone (ET) or estrogen combined with progestin (EPT) [3]. While perhaps less effective, several studies have also now demonstrated a role for SSRIsand SNRIs in treatment of vasomotor symptoms [4] .  \nEven among patients without a cancer history, systemic hormone therapy with ET and combined EPT carries certain risks, particularly for thromboembolism, cardiovascular disease, breast cancer, and endometrial cancer in the case of ET. These risks were highlighted after the release of the initial findings ofthe Women’s Health Initiative, leading to a  \nsignificant decrease ","cbCaidZh22wloYul","https://ap.wps.com/l/cbCaidZh22wloYul","pdf",565432,"English","# Opinion Statement\n# Introduction\n## Menopause and Hormone Replacement Therapy\n## Induced Menopause and Symptom Burden\n## Treatment Options and Risk Considerations\n## Local Vaginal Therapy for GSM\n## Alternatives to Hormone Therapy","[{\"question\":\"Which gynecologic cancer survivors may safely use hormone replacement therapy (HRT)?\",\"answer\":\"Survivors of early-stage, low-grade endometrial cancers; epithelial and germ cell ovarian cancers; and early-stage squamous cell cervical, vulvar, and vaginal cancers may use HRT. Patients who have undergone risk-reducing surgery for BRCA or Lynch syndrome mutations are also included.\"},{\"question\":\"When is HRT ideally initiated after menopause for eligible patients?\",\"answer\":\"HRT is ideally initiated in patients younger than age 60 or within ten years of menopause, after individualized discussion of risks, benefits, and symptom severity.\"},{\"question\":\"What are the recommended hormone regimens for different menopausal symptoms in this population?\",\"answer\":\"Low-dose vaginal estrogen is highlighted for vulvovaginal symptoms, while low-dose systemic estrogen is highlighted for vasomotor symptoms. Progesterone should be combined when the uterus is intact.\"}]","Updates in Hormone Replacement Therapy for Survivors of Gynecologic Cancers - Opinion Statement | PDF",1790188185]