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If symptoms persist, topical vaginal estrogen is the most effective pharmacologic treatment, directly restoring mucosal integrity with minimal systemic absorption

Furthermore, while these agents are relatively selective at standard doses, coadministration with serotonergic drugs like selective serotonin reuptake inhibitors requires caution due to the risk of precipitating serotonin syndrome , characterized by autonomic instability, altered mental status, and neuromuscular hyperactivity

[DOI] [PMC free article] [PubMed] [Google Scholar] 125.Chang CC, Dinh TK, Lee YA, et al

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This enhancement of GSH production also augments the stemness-like activities of cancer cells