Journal of the European Society for Gynaecological Endoscopy


Clinical guidelines for managing menopausal symptoms in women with (a history of) breast cancer

J. Servayge1, A.C. Verduyn2, A. Page1, L. Lagaert3, W.A.A. Tjalma4

1 Department of Gynaecology, University Hospital Ghent, 9000 Ghent, Belgium
2 Department of Gynaecology, CHU Saint Pierre, 1000 Brussels, Belgium
3 Department of Gynaecology, AZ Sint-Elisabeth Zottegem, 9620 Zottegem, Belgium
4 Multidisciplinary Breast Clinic, Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650 Edegem, Belgium


Menopause, symptoms, breast cancer, menopausal symptoms, hormone replacement therapy, tamoxifen, aromatase inhibitors

Published online: Dec 13 2023


Background: One in eight women will be diagnosed with breast cancer. At the time of diagnosis, 75% of patients are postmenopausal. Many will receive anti-hormone therapy, which often induces menopausal symptoms. Premenopausal breast cancer patients frequently become postmenopausal as a result of the treatment and often experience menopausal symptoms. The increased incidence of breast cancer, combined with longer survival, has led to an increase in the number of women experiencing menopausal symptoms. Therefore, the management of menopausal symptoms in women with a history or current breast cancer is a relevant and common clinical problem.

Objectives: To provide a clinically useful overview of the steps in the management of menopausal symptoms in women with (a history of) breast cancer.

Materials and methods: A comprehensive literature review was conducted by authors JS and WT using the PubMed and Medline databases. Abstracts were critically appraised and, where appropriate, the full text was analysed.

Main outcome measures: Not applicable.

Results: Depending on the condition, either meta-analyses, randomised controlled trials or retrospective cohorts were identified. No evidence was found for some proposed treatments.

Conclusions: Menopausal symptoms in women with (a history of) breast cancer require a patient-tailored approach. Shared decision making is paramount and adequate up-to-date knowledge can help the breast cancer specialist to advise and guide patients accordingly.

What is new? A comprehensive, clinically-based overview of evidence-based treatment options for menopausal symptoms in women with (a history of) breast cancer.