**5. Conclusions**

According to preclinical data, estrogen and progesterone are thought to play a role in the induction and progression of endometrial cancers. When the data is examined, epithelial ovarian cancer (EOC) appears to be at least partially hormonally affected. Considering the literature, the use of HRT is controversial in gynecologic cancer survivors. Given the fear of recurrence and the risk of developing ovarian or endometrial cancer most clinicians are reluctant to write HRT prescriptions for these patients but HRT does not appear to be associated with an increased risk of relapse in ovarian and endometrial cancer survivors, especially when used for a short period of time. In order to make an inference in terms of cervical cancer, squamous cell cancer is not associated with estrogen as mentioned above, but the risk of cervical adenocarcinoma increased significantly in women receiving estrogen therapy. Prior to the decision to use HRT, it is imperative that a proper consultation is done to individualize treatment on the basis of potential risks and benefits, including close follow-ups. However, with strongly informed consent, we believe that physicians may consider writing a course of HRT treatment to minimize menopausal symptoms and illnesses related to hormonal reduction on an individual basis.

In conclusion, further studies are needed for the role of hormonal modulation in the development, treatment, and management of climacteric symptoms after diagnosis, despite the modern emphasis of precision medicine in cancer care. In the patient group diagnosed with gynecological cancer, it is necessary to better define the conditions in which HRT can provide benefit or harm. Although there are some pre-clinical and epidemiological evidence that contradicts individual experience, observational or small randomized studies, there are available data in the literature to advice women on general and specific risks and benefits of HRT. Given high discontinuation rates and low medical compliance, we still have much to do in terms of informing women about the advantages and disadvantages of HRT and encouraging the appropriate use of HRT. Finally, to the extent that we can get rid of progressive diseases such as cancer, we can achieve the expected successful healthy aging goal.
