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dc.contributor.authorWitherby, Sabrina
dc.contributor.authorJohnson, Julia V.
dc.contributor.authorDemers, Laurence
dc.contributor.authorMount, Sharon
dc.contributor.authorLittenberg, Benjamin
dc.contributor.authorMaclean, Charles D.
dc.contributor.authorWood, Marie
dc.contributor.authorMuss, Hyman
dc.date2022-08-11T08:10:06.000
dc.date.accessioned2022-08-23T16:56:01Z
dc.date.available2022-08-23T16:56:01Z
dc.date.issued2011-04-01
dc.date.submitted2013-01-23
dc.identifier.citation<p>Oncologist. 2011;16(4):424-31. doi: 10.1634/theoncologist.2010-0435. <a href="http://dx.doi.org/10.1634/theoncologist.2010-0435" target="_blank"> Link to article on publisher's site</a></p>
dc.identifier.issn1083-7159 (Linking)
dc.identifier.doi10.1634/theoncologist.2010-0435
dc.identifier.pmid21385795
dc.identifier.urihttp://hdl.handle.net/20.500.14038/42841
dc.description.abstractPURPOSE: Controversy exists about whether vaginal estrogens interfere with the efficacy of aromatase inhibitors (AIs) in breast cancer patients. With the greater incidence of vaginal atrophy in patients on AIs, a safe and effective nonestrogen therapy is necessary. We hypothesized that vaginal testosterone cream could safely treat vaginal atrophy in women on AIs. METHODS: Twenty-one postmenopausal breast cancer patients on AIs with symptoms of vaginal atrophy were treated with testosterone cream applied to the vaginal epithelium daily for 28 days. Ten women received a dose of 300 mug, 10 received 150 mug, and one was not evaluable. Estradiol levels, testosterone levels, symptoms of vaginal atrophy, and gynecologic examinations with pH and vaginal cytology were compared before and after therapy. RESULTS: Estradiol levels remained suppressed after treatment to <8 pg/mL. Mean total symptom scores improved from 2.0 to 0.7 after treatment (p < .001) and remained improved 1 month thereafter (p = .003). Dyspareunia (p = .0014) and vaginal dryness (p <.001) improved. The median vaginal pH decreased from 5.5 to 5.0 (p = .028). The median maturation index rose from 20% to 40% (p < .001). Although improvement in total symptom score was similar for both doses (-1.3 for 300 μg, -0.8 for 150 μg; p = .37), only the 300-μg dose was associated with improved pH and maturation values. CONCLUSIONS: A 4-week course of vaginal testosterone was associated with improved signs and symptoms of vaginal atrophy related to AI therapy without increasing estradiol or testosterone levels. Longer-term trials are warranted.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=21385795&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1634/theoncologist.2010-0435
dc.subjectAdministration, Intravaginal
dc.subjectAged
dc.subjectAntineoplastic Agents
dc.subjectAromatase Inhibitors
dc.subjectAtrophy
dc.subjectBreast Neoplasms
dc.subjectEstradiol
dc.subjectEstrogens
dc.subjectFemale
dc.subjectHumans
dc.subjectMiddle Aged
dc.subjectPilot Projects
dc.subjectTestosterone
dc.subjectVagina
dc.subjectFemale Urogenital Diseases and Pregnancy Complications
dc.subjectNeoplasms
dc.subjectObstetrics and Gynecology
dc.subjectOncology
dc.titleTopical testosterone for breast cancer patients with vaginal atrophy related to aromatase inhibitors: a phase I/II study
dc.typeJournal Article
dc.source.journaltitleThe oncologist
dc.source.volume16
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/obgyn_pp/56
dc.legacy.embargo2013-01-24T00:00:00-08:00
dc.identifier.contextkey3609772
html.description.abstract<p>PURPOSE: Controversy exists about whether vaginal estrogens interfere with the efficacy of aromatase inhibitors (AIs) in breast cancer patients. With the greater incidence of vaginal atrophy in patients on AIs, a safe and effective nonestrogen therapy is necessary. We hypothesized that vaginal testosterone cream could safely treat vaginal atrophy in women on AIs.</p> <p>METHODS: Twenty-one postmenopausal breast cancer patients on AIs with symptoms of vaginal atrophy were treated with testosterone cream applied to the vaginal epithelium daily for 28 days. Ten women received a dose of 300 mug, 10 received 150 mug, and one was not evaluable. Estradiol levels, testosterone levels, symptoms of vaginal atrophy, and gynecologic examinations with pH and vaginal cytology were compared before and after therapy.</p> <p>RESULTS: Estradiol levels remained suppressed after treatment to <8 pg/mL. Mean total symptom scores improved from 2.0 to 0.7 after treatment (p < .001) and remained improved 1 month thereafter (p = .003). Dyspareunia (p = .0014) and vaginal dryness (p <.001) improved. The median vaginal pH decreased from 5.5 to 5.0 (p = .028). The median maturation index rose from 20% to 40% (p < .001). Although improvement in total symptom score was similar for both doses (-1.3 for 300 μg, -0.8 for 150 μg; p = .37), only the 300-μg dose was associated with improved pH and maturation values.</p> <p>CONCLUSIONS: A 4-week course of vaginal testosterone was associated with improved signs and symptoms of vaginal atrophy related to AI therapy without increasing estradiol or testosterone levels. Longer-term trials are warranted.</p>
dc.identifier.submissionpathobgyn_pp/56
dc.contributor.departmentDepartment of Obstetrics and Gynecology
dc.source.pages424-31


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