Genitourinary syndrome of menopause with a history of breast cancer. Clinical case

Genitourinary syndrome of menopause in a 61-year-old woman with a history of breast cancer. Clinical case.

In today's article, Dr. Elisa Llurba, gynecologist, obstetrician and director of beDona, shares with us the clinical case of a 61-year-old woman with genitourinary syndrome of menopause with a history of breast cancer. 

Esther

Current symptoms:

• 61-year-old patient consulting for:
  • Urinary symptoms with recurrent urinary tract infections.
  • Urge urinary incontinence: you leak urine when you get home or when you enter the bathroom.
  • Dyspareumia: Pain during sexual intercourse in the vagina during penetration, which Esther describes as "like knives". 
• She went through menopause at age 45 as a result of breast cancer treatment.

During our visit to beDona, we assessed:

• Gynecological examination: The external and internal genitalia show signs of atrophy, with thin, reddened skin and mucous membranes, absence of discharge, and a narrow vagina, painful even upon single-finger palpation. She presents with incontinence upon minimal exertion.

• Following the functional visit We value the following THERAPEUTIC PLAN:

1. VAGINAL HORMONE TREATMENT:
   1. Estradiol vaginal gel: vaginal treatment is completely safe as it is not absorbed systemically and has been shown to have no effect on the risk of breast cancer recurrence. 
   2. Anti-inflammatory diet to improve the intestinal and vaginal microbiota, reducing the risk of urinary tract infections.
   3. Oral probiotics to help improve intestinal and vaginal flora.
   4. Vesicare to improve urinary symptoms and avoid urgency when going to the bathroom.
   5. Pelvic floor rehabilitation with the pelvic floor specialist physiotherapist at beDona, Carla Box.

RESULTS

Three months later, Esther is feeling much better. She hasn't had another urinary tract infection, and her urinary urgency symptoms have improved. She also feels more lubricated vaginally and has started trying penetrative sex with her partner without pain. Esther is very grateful that this vaginal estrogen treatment is easy and affordable since it's covered by insurance. She says, "It's changed my life.".

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Genitourinary Syndrome (GDS) affects postmenopausal women (70%) with varying degrees of severity. It is caused by a lack of estrogen, which results in thinner skin and mucous membranes in the vulvo-genital and urinary tract, reduced lubrication, and changes in vaginal pH that increase the risk of urinary tract infections. This leads to atrophy of the entire area, making sexual intercourse and achieving orgasm difficult. 

To learn more about Genitourinary Syndrome, we encourage you to read the article:; Urinary incontinence in menopause And if you'd like one of our professionals to assess your case, you can schedule a one-on-one consultation at beDona. Contact us via WhatsApp at +34 644 61 24 52 or by email at info@be-dona.com.