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Breast cancer drug reported to cause sexual dysfunction

Robin Wulffson MD's picture
breast cancer, libido, sexual dysfunction,  tamoxifen, aromatase inhibitors

A new study by Swedish researchers has reported that certain hormone-blocking drugs to reduce the risk of breast cancer recurrences impact a woman’s sex life. Researchers affiliated with Örebo University Hospital (Örebo, Sweden) published their findings online on September 17 in the journal Menopause.

The goal of the study was to evaluate the effect of aromatase inhibitors on the sexual function of postmenopausal breast cancer patients. Aromatase is the enzyme which manufactures estrogen. Many breast and ovarian cancers require estrogen to grow; thus, aromatase inhibitors are taken to either block the production of estrogen or block the action of estrogen on receptors.

The study group comprised 82 women who were taking aromatase inhibitors or tamoxifen. They were between 55 and 70 years of age and had been diagnosed with breast cancer two-to-six years earlier. Sexual function was assessed with a standardized questionnaire. The researchers compared those women’s responses to those from 102 women of the same age who had not been diagnosed with breast cancer. Most women in both the cancer and non-cancer groups reported that they were sexually active.

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The researchers found that, overall, 42.4% of aromatase inhibitor-treated breast cancer patients were dissatisfied with their sex life in general; furthermore, 50.0% reported low sexual interest. The researchers found that sexual dysfunction was significantly more common in the women treated with aromatase inhibitors, compared to the tamoxifen-treated patients and controls. The majority of patients receiving aromatase inhibitors reported insufficient lubrication (73.9%); 56.5% of the women reported dyspareunia (painful intercourse). Both these percentages were significantly higher than the controls, irrespective of hormonal use. Tamoxifen-treated patients reported significantly more dyspareunia (31.3%); however, their responses were similar to the controls in all other concerns.

The researchers concluded: “Our findings suggest that sexual dysfunction in aromatase inhibitor-treated women is a greatly underestimated problem.”

Take home message:
This study found that both aromatase inhibitors and tamoxifen impacted sexual function. Lack of lubrication and dyspareunia are related problems. Lack of lubrication restricts motion and can result in painful chafing. A number of lubricants are available to promote sexual function. They are water soluble and non-greasy; thus, they are far superior to petroleum jelly (Vaseline). Decreased libido is another matter. This problem can be helped with counseling. Also books on the topic are available. Trust, communication, and getting out of comfort zones are important factors for restoring libido. Traditional Chinese medicine (TCM) has helped a number of women who suffer from sexual dysfunction. It is an approach that has addressed these issues for centuries. It uses a mind-body approach to illness and disease, and recognizes that decreasing vitality, including sexual energy, is part of aging. However, there are certain TCM protocols that any couple can follow to help get physical forms of affection back on the schedule.

Reference: Menopause

See also:
Does ovary removal impact sexual function in older women?
Tips to revitalize sex life after 50 with traditional Chinese medicine
Hormone replacement therapy use in US continues to decline