Mikuláš Redecha, Marián Križko ml., Peter Papcun, Sylvia Redechová, Martin Gábor, Karol Holomáň
Treatment of gynaecological cancer frequently results in the loss of ovarian function and menopausal symptoms. Symptoms
of iatrogenic menopause are usually significantly more intense than those of natural menopause. The most effective
treatment for menopausal symptoms is hormone replacement therapy. However, it is very controversial if hormone
replacement therapy is safe for these patients. The main concerns are the potential stimulation of residual cancer
and the induction of new hormone-dependent disease. The majority of the gynaecological malignancies like squamous
cell carcinomas of the cervix, serous papillary epithelial ovarian carcinomas and squamous cell carcinomas of the vulva
are not oestrogen dependent. Current scientific evidence does not show that HRT adversely affects the outcome
in patients after treatment for hormone sensitive cancers like an early stage of endometrioid adenocarcinomas of
the endometrium. There is only a small number of gynaecological malignancies like low grade endometrial stromal
sarcomas in which hormone replacement therapy is an absolute contraindication. Maintaining the quality of life and
minimising the physical and psychological impact of treatment side effects is one of the most important factors in cancer
care. It is therefore necessary to give patients unbiased information about their individual cancer which in most
cases will allow them to use HRT without any detrimental effect on their survival.