الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Vulvovaginal atrophy is a crucial component of genitourinary syndrome of menopause and is directly related to estrogen insufficiency. GSM symptoms in cancer survivors are more severe and chronic with earlier onset compared to those caused by natural menopause. Most of those women are undiagnosed and undertreated. It is critical to understand the importance of screening cancer patients or survivors for GSM symptoms and its impact on the quality of life.
The goal of treatment is to restore vulvar and vaginal physiology to normal, which will lessen the most bothersome symptoms. Systemic hormonal therapy is the most effective treatment for menopausal symptoms, but it is contraindicated for women with hormone receptor-positive breast cancer and other estrogen-dependent gynecological cancers. Low-dose local estrogen is also effective, but there is a significant concern about its use due to the probability of systemic absorption and slight increase in estrogen levels.
Alternative non-hormonal approaches have been recently investigated to improve symptoms of vulvovaginal atrophy among cancer survivors especially those who have history of hormonal dependent gynecological cancers.
To treat vaginal atrophy, a variety of substances are currently injected into the vaginal wall. PRP targets the pluripotent stem cells activation, mucosal regeneration, angiogenesis, matrix remodeling and reduction of fibrosis through the released platelet derived growth factors which leads to improvement of mucosal atrophy, vaginal fluid transudation, improvement of vaginal elasticity, increase in glycogen containing cells and so reduction of vaginal pH.