Patients surviving breast cancer, however, may have a wide variety of endocrine problems related to e strogen deficiency. Nevertheless, estrogen replacement therapy is considered to be contraindicated in these women. The approach used in the UVa Breast Cancer Clinic is directed toward treating patients' symptoms with drugs that bypass the need for estrogen. The following program description outlines the management of the patient for specific problems. Symptomatic vasomotor instability.
Several regimens can provide relief from hot flashes.
Our approach is graded, using different regimens that depend upon the severity of symptoms. Patients are initially given bellergal-s and then clonidine, megestrol acetate, or norethindrone acetate alone or in combination with clonidine. Dyspareunia and atrophic vaginitis. Standard therapy includes the use of vaginal moisturizing agents such as Replens or lubricants such as Astroglide. Vaginal conjugated estrogens topically in low doses a re available for selected patients.