# Hormone Replacement Therapy in Post-Menopause Hormone-Dependent Gynecological Cancer Patients: A Narrative Review

## TL;DR

This review explores the safety of hormone replacement therapy for women with a history of hormone-dependent gynecological cancers after menopause.

## Contribution

The paper provides updated guidance on HRT use in post-menopausal survivors of specific gynecological cancers.

## Key findings

- HRT may be considered for early-stage, grade I–II ovarian cancer patients with severe menopausal symptoms.
- HRT is not recommended for low-grade serous ovarian cancer or advanced endometrial cancer due to insufficient data.
- HRT is not contraindicated for cervical adenocarcinoma survivors and can be used in early-stage low-grade endometrial cancer.

## Abstract

Background. Advances in the treatment of gynecological cancer have led to improvements in survival but also an increase in menopausal symptoms, especially in young women with premature iatrogenic menopause. Methods. A narrative review was performed to clarify the possibility of prescribing hormone replacement therapy (HRT) after hormone-dependent gynecological cancers (ovarian cancer [OC], cervical adenocarcinoma [AC], and endometrial cancer [EC]). Results. HRT can be prescribed to patients with early-stage, grade I–II OC who experience bothersome menopausal symptoms non-responsive to alternative non-hormone therapy after optimal surgery. Caution should be exercised in administering HRT after serous borderline tumors and endometrioid OC, and HRT is not recommended in low-grade serous OC. HRT is not contraindicated in AC survivors. After surgery for EC, HRT can be prescribed in women with early-stage low-grade EC. There is not enough data to give indications to patients with advanced EC. Conclusions. HRT can be discussed with patients, evaluating the risks and benefits of hormone-dependent gynecological cancer. Counseling should be performed by gynecologic oncologists experienced in the management of these patients.