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Genitourinary syndrome of menopause (GSM) affects a large proportion of postmenopausal women and often compromises physical comfort, sexual health, and overall quality of life.
Weekly vaginal tamoxifen reduces anxiety symptoms and overall pain in postmenopausal women with genitourinary syndrome of menopause, while maintaining a favorable mental health and quality-of-life profile.
Genitourinary syndrome of menopause (GSM) affects a large proportion of postmenopausal women and often compromises physical comfort, sexual health, and overall quality of life. Although vaginal estrogen remains the standard treatment, many women—particularly breast cancer survivors—cannot or prefer not to use estrogen-based therapies.
Vaginal tamoxifen has previously shown potency in ameliorating GSM symptoms. However, its effects on psychological well-being and health-related quality of life (HRQoL) have not been established. Hence, this study explored whether vaginal tamoxifen influences depression, anxiety, and HRQoL in postmenopausal females with and without breast cancer.
This randomized controlled trial enrolled 115 postmenopausal women, including 23.5% with breast cancer. Participants were randomized to receive once-weekly vaginal tamoxifen or placebo for 3 months. Anxiety, depression, and HRQoL were assessed via validated standardized questionnaires at baseline and after treatment. Mixed-design analyses of variance (ANOVAs) were performed to assess treatment effects over time in the overall study population and in the breast cancer subgroup.
Among the 115 participants, 23.5% had breast cancer. Vaginal tamoxifen produced a prominent treatment-by-time interaction for anxiety, with anxiety symptoms declining modestly during treatment, while remaining unchanged in the placebo group. Although baseline anxiety scores were below clinically significant thresholds, the improvement suggested a favorable effect on emotional well-being.
Importantly, vaginal tamoxifen also achieved a clinically meaningful reduction in overall pain vs. placebo. No significant between-group differences were noted for depression or HRQoL, and the findings were consistent in women with breast cancer.
Once-weekly vaginal tamoxifen offered a promising non-estrogen therapeutic option for postmenopausal women with GSM by improving anxiety symptoms and providing clinically meaningful pain relief.
Maturitas
The effect of vaginal tamoxifen on symptoms of anxiety, depression, and health-related quality of life in postmenopausal women with and without breast cancer
Serenay Yazici Sarikaya et al.
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