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More survivors now live long enough to experience treatment\u2010related menopause. Vasomotor symptoms, genitourinary syndrome of menopause, sexual dysfunction, sleep issues, and long\u2010term risks from estrogen deficiency can seriously impact quality of life. Despite increased survival, managing menopausal symptoms remains difficult, as concerns about cancer recurrence and hormone therapy safety often result in inconsistent or insufficient treatment. This article explores clinical considerations for menopausal hormone therapy (MHT) in women with a history of gynecologic cancer. It reviews evidence on the safety of MHT after vulvar, vaginal, cervical, uterine, and ovarian cancers, providing an overview of tumor histology, stage, and hormonal sensitivity. It also synthesizes observational studies, systematic reviews, and international guidelines to help clinicians deliver menopausal care to cancer survivors. Current evidence suggests that systemic MHT may be suitable for carefully chosen survivors of non\u2013hormone\u2010dependent gynecologic cancers, including most vulvar, vaginal, cervical, and epithelial ovarian cancers. Patients with hormonally sensitive tumors should generally avoid systemic MHT, while local vaginal hormonal administration and non\u2010hormonal options remain important in these cases. Given the disproportionate burden of gynecologic cancers in low\u2010 and middle\u2010income countries, where younger women face increased risks of treatment\u2010induced menopause and limited survivorship resources, this paper emphasizes context\u2010specific, resource\u2010aware strategies to promote equitable care. By enhancing personalized and evidence\u2010based decision\u2010making, we aim to improve quality of life for women during menopause after cancer treatment, while ensuring safe, fair, and widely applicable survivorship approaches.<\/jats:p>","DOI":"10.1002\/ijgo.71188","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:45:52Z","timestamp":1784709952000},"page":"1151-1171","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Menopausal hormone therapy and comprehensive postmenopausal care in gynecologic cancer survivors: A position paper from the\n                    <scp>FIGO<\/scp>\n                    Committee on Women at Menopausal Age"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8486-7861","authenticated-orcid":false,"given":"Agnaldo Lopes","family":"da Silva\u2010Filho","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine Federal University of Minas Gerais (UFMG)  Belo Horizonte Brazil"},{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suvarna","family":"Khadilkar","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"Gynecology and Obstetrics Department Bombay Hospital Institute of Medical Sciences  Mumbai India"},{"name":"Bombay Hospital Medical Research Center  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hema","family":"Divakar","sequence":"additional","affiliation":[{"name":"FIGO Division of Well Woman HealthCare FIGO  London UK"},{"name":"Divakar Specialty Hospital  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Benedetto","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"Sant'Anna University Hospital  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea R.","family":"Genazzani","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Ramos","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"California Surgeon General  Sacramento California USA"},{"name":"Keck University of Southern California School of Medicine  California USA"},{"name":"Women's Preventive Services Initiative Implementation Committee American College of Obstetricians and Gynecologists (ACOG)  Washington D.C Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabete","family":"Argale","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"Department of Obstetrics and Gynecology Riga Stradins University  Riga Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Herrera","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"Department of Obstetrics and Gynecology; Coordinator, Area of Endocrinology, Gynecology and Human Reproduction Universidad del Valle  Cali Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Hickey","sequence":"additional","affiliation":[{"name":"FIGO Committee on Women at Menopausal Age FIGO  London UK"},{"name":"Department of Obstetrics, Gynaecology and Newborn Health University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.6987"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2022.102396"},{"key":"e_1_2_11_6_1","unstructured":"National Comprehensive Cancer Network.Survivorship (Version 2026).2026.https:\/\/www.nccn.org"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31121"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02802-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.574263"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02800-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21319"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31392-7"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13051443"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgc.2025.102809"},{"key":"e_1_2_11_15_1","volume-title":"Menopause: Diagnosis and Management. 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