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In original publication, the Fig. 1 was incorrect. The correct figure has been given below.

The aim of this study was to evaluate the efficacy of fractional CO2 laser therapy in breast cancer survivors as a therapeutic method for vulvovaginal atrophy (VVA) dyspareunia. 50 patients (mean age 53.3 years) underwent fractional microablative CO2 laser treatment for dyspareunia in oncological menopause (mean time of menopause 6.6 years). The Gloria Bachmann’s Vaginal Health Index (VHI) score was chosen as system to evaluate the presence of VVA and its improvement after the treatment. Intensity of dyspareunia was evaluated using a visual analog scale (VAS). Data indicated a significant improvement in VVA dyspareunia (p

The composition of vaginal microbiome in menopause and cancer survivor women changes dramatically leading to genitourinary syndrome of menopause (GSM) in up to 70% of patients. Recent reports suggest that laser therapy may be valuable as a not hormonal therapeutic modality. The aim of the present study was to evaluate the effects of fractional CO2 laser treatment on the vaginal secretory pathway of a large panel of immune mediators, usually implicated in tissue remodeling and inflammation, and on microbiome composition in postmenopausal breast cancer survivors. The Ion Torrent PGM platform and the Luminex Bio-Plex platform were used for microbiome and immune factor analysis. The significant reduction of clinical symptoms and the non-significant changes in vaginal microbiome support the efficacy and safety of laser treatment. Moreover, the high remodeling status in vaginal epithelium is demonstrated by the significant changes in inflammatory and modulatory cytokine patterns. Laser therapy can be used for the treatment of GSM symptoms and does not show any adverse effects. However, further studies will be needed to clarify its long-term efficacy and other effects.

In original publication, the Fig. 1 was incorrect. The correct figure has been given below.

The aim of this study was to evaluate long-term effects of the fractional COWomen presenting with VVA symptoms and meeting inclusion criterion were enrolled to fractioned CO184 patients constituted the final study group: 128 women were spontaneous menopause and 56 were oncological menopause. 117 women were nulliparous and 36 had previous hysterectomy. 95.4% (172/184) of the patients declared that they were satisfied or very satisfied with the procedure at 4 weeks after treatment. At 6 months 92% (170/184) patients were satisfied; at 12 months 72% (118/162) were satisfied; at 18 months 63% (60/94) were satisfied; at 24 months 25% (4/16) of patients answered they were still satisfied. We observed a decline in patient's satisfaction between 18 and 24 months after laser therapy. Data showed that the time interval from onset of menopause was a statistically significant factor (p 0.05) for treatment satisfaction in oncological group.Long-term data showed that the improvement of vaginal health may continue up to 24 months after fractional CO

Breast cancer therapy after surgery has been improved in recent years. Adjuvant therapies like aromatase inhibitors are being extensively used among breast cancer survivors. This leaded to cancer related and iatrogenic osteoporosis. Management of these patients needs to be focused and differentiated from the standard age related osteoporosis in women. All guidelines consider mandatory to assess fracture risk periodically in all breast cancer survivors. Risk assessment diagnostic FRAX tool is the most used but it's not born specifically for cancer related osteoporosis. The therapeutic management of this kind of osteoporosis has been studied by different societies. Since breast cancer survivors are at risk of osteopenia and osteoporosis, counseling regarding modifiable risk factors is mandatory and advocated. The beginning of the treatment should be tailored in each patient.

Owing to the improved effectiveness of the treatment protocols for oncological disease, in the last few years we have seen an increase in the number of women in iatrogenic menopause secondary to integrated oncological treatments or surgical, pharmacological or radiological therapies. Particularly if it is premature, menopause in these subjects, who are already strongly debilitated by the primary pathology, may have heavy physical and psychic repercussions on the quality of life.Particular attention must be paid to the prevention and treatment of osteoporosis, which is linked both to premature cessation of the reproductive capacity and to the treatments for the oncological disease, which may represent an additional risk for the development of premature, severe osteoporosis. Some oncological diseases involve therapies which affect bone metabolism. At the sametime, for example in breast cancer, some bone protective drugs like hormone replacement therapy are controindicated. The introduction for breast cancer of a new category of drugs, aromatase inhibitors, seems to be linked to an increase in bone fractures. Correct treatment of these subjects involves a multidisciplinary specialist approach which we believe can be created through a targeted menopause surgery, which would thus become the ideal place for the evaluation of problems linked to the treatment of cancer and the consequent early menopause.A targeted surgery like this allows us to create individual treatment paths with differentiated timing, and to address questions which are still unanswered, such as the risk of osteoporosis deriving from the effects of aromatase inhibitors on the bones, and the preventive effectiveness of the combination with bisphosphonates.

Objective: Leptin, a protein secreted by white adipocytes, plays a relevant role in the regulation of body weight and food intake. A possible role for sex hormones in the regulation of leptin secretion has been suggested; however, the effect of variations in oestrogen concentration on serum leptin levels has not been described so far. Methods: In study 1, serum leptin concentrations were measured on days 3, 10, 17 and 24 of the menstrual cycle in 18 healthy, lean, regularly menstruating women, aged 18‐35 years. Serum oestradiol, progesterone, testosterone, D 4 -androstenedione, dehydroepiandrosterone sulphate (DHEAS), LH and FSH concentrations were also determined. In study 2, serum leptin and oestradiol levels were measured on the 5th and 7th day of ovarian stimulation with human FSH (225 IU daily) during an in vitro fertilisation programme for infertility in 20 women aged 25‐45 years. Results: The results from study 1 show a physiological fluctuation of leptin levels during the menstrual cycle, which has not been described previously. Leptin levels are significantly lower in the early follicular phase. The results of study 2 show a parallel increase in serum oestrogen and leptin concentrations during FSH administration. Conclusions: The fluctuation in leptin levels during the menstrual cycle observed in study 1 is compatible with the hypothesis of a stimulatory effect of oestrogen on leptin secretion. The results of study 2 support the hypothesis of a relevant role for oestrogen in the regulation of leptin secretion. Leptin fluctuations during the menstrual cycle are consistent with reported perimenstrual variations in food craving and consumption.