Table 1.

Interventions tested for vaginal dryness and/or loss of libido

Therapy	Efficacy endpoints	Hormones measured	Breast cancer Pts included	Results
Polycarbophil based vaginal moisturizer (Replens) [32]	Vaginal dryness, dyspareunia	None	Yes	Decreased vaginal dryness and dyspareunia
17beta-estradiol vaginal tablet (Vagifem) [20, 21, 24, 25]	Atrophic vaginitis symptoms	Serum estradiol, total estrone	Yes, only in one study [25]	Improvement in atrophic vaginitis [20]
				Improvement in vaginal atrophy and urinary symptoms [21]
				Improvement in vaginal maturation with no increase in endometrial proliferation. Estradiol levels rose but remained within the normal postmenopausal range [24]
				Significant increase in estradiol levels in some pts [25]
Conjugated equine estrogen vaginal cream (Premarin) [20]	Atrophic vaginitis symptoms	Serum estradiol	No	Improvement in atrophic vaginitis but more endometrial proliferation than with Vagifem [20]
Topical estriol cream (Synapause®) [22]	Vaginal dryness	None	No	Improved vaginal dryness and atrophy
Estradiol vaginal ring (Estring) [22, 24, 53]	Vaginal dryness	Serum estradiol, total estrone, testosterone	Yes, only in one ongoing study [53]	Improved vaginal dryness and atrophy [22]
				Improvement in vaginal maturation with no increase in endometrial proliferation. Estradiol levels rose but remained within the normal postmenopausal range [24]
Transdermal testosterone patch [49, 50]	Sexual activity, orgasm	Serum testosterone	No	Increase in frequency of sexual activity and pleasure [49]
				Increase in sexual desire, decreased distress [50]
Transdermal testosterone in Vanicream [52]	Sexual desire	Serum testosterone	Yes	No significant improvement in libido
Vaginal testosterone cream [53]	Vaginal dryness, libido	Serum estradiol, total testosterone	Yes	Ongoing study
Pilocarpine [54]	Vaginal dryness	None	Yes	Ongoing study