Background: Vulvovaginal atrophy (VVA) significantly impacts the quality of life in
breast cancer patients leading to symptoms like vaginal dryness, dyspareunia, and
genital discomfort. Quality of life in this context is measured using validated scales
like the Vaginal Health Index, Visual Analog Scale (VAS), and the Female Sexual Function
Index (FSFI). Methods: We performed a systematic review and meta-analysis to identify
effective treatment options for VVA, including topical estrogen, systemic hormone
therapy, vaginal DHEA, ospemifene, and non-hormonal methods like intravaginal laser
therapy, moisturizers, and lubricants. A systematic search of four databases (MEDLINE,
Scopus, CENTRAL, Embase) identified studies on VVA treatment efficacy in breast cancer
patients, yielding 13,039 records, with 32 eligible studies and 8 included in the
meta-analysis. Results: Significant improvements were found with intravaginal laser
therapy, showing notable differences in the Vaginal Health Index (MD = 8.24, p < 0.01),
dyspareunia (MD = -4.82, p = 0.05), and dryness (MD = -5.05, p = 0.01). However, no
significant changes were observed in FSFI and vaginal pH. Notably only intravaginal
laser therapy was included in the meta-analysis, as other treatment options lacked
comparable data. Both hormonal and non-hormonal treatments improved quality of life,
with laser therapy showing the most substantial effects. Conclusions: Intravaginal
laser therapy is an effective treatment for VVA symptoms in breast cancer survivors,
particularly in improving the Vaginal Health Index and reducing dyspareunia. Despite
the strengths of the study, variability among studies, lack of RCT-s and data limitations,
especially on long-term effects, present challenges.
