Genitourinary syndrome of menopause among breast cancer survivors: an untold story

Objective Genitourinary syndrome of menopause (GSM) is a common symptom among breast cancer survivors (BCSs). However, its impact on the quality of life of BCSs is not routinely addressed by all healthcare providers. Similarly, not all patients consult their healthcare providers regarding these symptoms. In this study, we aimed to investigate the proportion of BCSs who reported GSM symptoms and to explore their attitudes toward disclosing these symptoms. Methods This cross-sectional study was conducted from April 2022 to March 2023 at two tertiary university hospitals in southern Thailand. BCSs completed a self-reported questionnaire containing information regarding GSM. Descriptive statistics and binary logistic regression analyses were used to identify factors influencing the disclosure of GSM symptoms by BCSs. Results The mean age of the 173 participants was 49.0±9.2 years. 45.7% (79/173) of BCSs reported at least one GSM symptom. The most common symptoms were nocturia (45.7%) and vaginal dryness (45.1%). Among the symptomatic women, 61.8% never disclosed their symptoms due to embarrassment. Among those who disclosed GSM symptoms, 31.8% reported them to their spouses, while 25.8% and 19.7% disclosed them to their gynaecologists and family, respectively. A higher education level was significantly associated with symptom disclosure (OR, 4.38; 95% CI, 1.58–12.12; p=0.004). Most participants (97.7%) believed that physicians should initiate discussions on GSM. Conclusion GSM is prevalent but under-reported among Thai BCSs, possibly due to cultural embarrassment. Healthcare providers should adopt a proactive, culturally sensitive approach to facilitate early identification and individualised care for GSM symptoms in this population, thereby enhancing the quality of life of BCSs.