New RANZCOG guidelines

[u/Professional-Loan663]

https://ranzcog.edu.au/news/menopause-guideline-vasomotor-genitourinary-symptoms/

The main callout is that they are recommending vaginal estrogen even for people with some types of breast cancer

RANZCOG are the Royal Australia & New Zealand College of Obstetricians and Gynaecologists

[u/Ill-Telephone8928]

about damn time they updated this. my aunt was denied vaginal estrogen for years because of her breast cancer history and she was basically suffering in silence with constant UTIs and discomfort. doctors treat it like its the same as systemic estrogen when the absorption is so minimal

the link between treating GSM and better quality of life isnt even controversial anymore just took forever for official guidelines to catch up

wonder how long until GPs actually read these guidelines though cause half of them still think menopause is just hot flashes and mood swings

[u/leftylibra]

As well... from our Menopause Wiki:

Vaginal estrogen and breast cancer.

The 2025 American Urological Association guideline statements #19-#21 indicates that "while there are no data stratifying the risk for breast cancer in users of local low-dose vaginal estrogen who have an above average or high risk for breast cancer, data suggest that local low-dose vaginal estrogen does not increase the risk for recurrence or of breast cancer mortality in women with a personal history of breast cancer." Also, those "with a personal history of breast cancer are at high risk for developing GSM, sexual dysfunction, and issues with vaginal health. Endocrine therapies, including tamoxifen and AI, are an important component of the treatment on estrogen-dependent breast cancers, which make up 80% of all breast cancers. Because these therapies lower estrogen levels, the symptoms of GSM in breast cancer patients are more magnified."

An analysis of data on 49,237 women with breast cancer from two national registries in Scotland and Wales showed no increase in cancer-specific mortality was seen among women in the cohort who used vaginal estrogen. In a 2024 systematic review and metanalysis, which included eight observational studies of breast cancer survivors with GSM, there was no increased risk for breast cancer recurrence (OR: 0.48; n=24,060) in users of vaginal estrogen, nor was there an increase in breast cancer mortality (OR: 0.60; n=61695), or overall mortality.