Limitations
vaginal atrophy, breast cancer
VAGINAL ATROPHY, BREAST CANCER
This study has some limitations. Our study was limited to survivors of breast cancer undergoing treatment with aromatase inhibitors, which produces ultra-low levels of serum estradiol and may induce a more severe and rapid vaginal atrophy in this subgroup of patients. Therefore, response to the FLT or vaginal laser treatment might be different from that of other populations. This study was performed during the COVID-19 pandemic; therefore, the loss of participants to follow-up was considerable, even though the calculated sample size was achieved. This study did not include a control group without intervention, since it is mandatory to provide FLT to patients presenting symptomatic moderate to severe GSM and to do otherwise would be unethical. Two of the objective outcomes assessed, the VET and VEE, are rarely used in the literature; therefore, further studies are needed to validate their ability to characterize vaginal tissue. Nonetheless, they seem to be promising diagnostic tools for objective evaluation of patients diagnosed with GSM. Additionally, this study described the evaluation of medium-term follow-up (6 months), but further data regarding long-term follow-up is currently being recorded.