Lemke Emily A, Madsen Lydia T, Dains Joyce E
University of Texas MD Anderson Cancer Center.
University of Texas Health Science Center.
Oncol Nurs Forum. 2017 May 1;44(3):296-301. doi: 10.1188/17.ONF.296-301.
PROBLEM IDENTIFICATION: Women taking aromatase inhibitors (AIs) as part of the management of hormone receptor-positive breast cancer experience more symptoms of sexual dysfunction, including vaginal atrophy, as opposed to postmenopausal women and women treated with tamoxifen (Nolvadex®). Vaginal testosterone could be an alternative to estrogen, which is contraindicated in this population. .
LITERATURE SEARCH: A systematic review was completed by searching PubMed and Scopus databases. .
DATA EVALUATION: 64 search results were reduced to a final sample of 3 articles after applying inclusion and exclusion criteria. .
SYNTHESIS: Published results suggest that vaginally applied testosterone doses of 150 mcg and 300 mcg improve symptoms of sexual dysfunction in women taking AIs. Minimal side effects are observed, and estradiol levels are not affected by vaginally applied testosterone. Additional research is needed to evaluate vaginal testosterone in women taking AIs. .
CONCLUSIONS: Vaginal testosterone shows preliminary promise as an option to manage sexual side effects of AI therapy in postmenopausal cancer survivors; however, available data are too limited to draw practice-changing conclusions. .
Large-scale randomized, controlled trials need to be completed to evaluate the efficacy and safety of vaginal testosterone in women taking AIs.
与绝经后女性及接受他莫昔芬（诺瓦得士®）治疗的女性相比，服用芳香化酶抑制剂（AIs）作为激素受体阳性乳腺癌治疗一部分的女性出现更多性功能障碍症状，包括阴道萎缩。阴道用睾酮可能是雌激素的替代物，而雌激素在该人群中是禁忌的。
通过检索PubMed和Scopus数据库完成了一项系统评价。
在应用纳入和排除标准后，64条检索结果被缩减为3篇文章的最终样本。
已发表的结果表明，阴道应用150微克和300微克剂量的睾酮可改善服用AIs女性的性功能障碍症状。观察到的副作用最小，且阴道应用睾酮不影响雌二醇水平。需要进一步研究以评估服用AIs女性使用阴道用睾酮的情况。
阴道用睾酮作为管理绝经后癌症幸存者AI治疗性副作用的一种选择显示出初步前景；然而，现有数据过于有限，无法得出改变临床实践的结论。
需要完成大规模随机对照试验，以评估阴道用睾酮对服用AIs女性的疗效和安全性。
