Breast Cancer and Sexual Function

As the most common malignancy affecting women within the United States, breast cancer can bring about multiple physical and psychological challenges. Among the greatest challenges are those associated with female sexual function. 

Chemotherapy, endocrine therapy, surgeries and radiation can all have a large effect in altering a woman's sexual health and function. Sexual concerns result in significant emotional distress, including sadness/depression, issues related to personal appearance, stigma, and negative impacts on personal relationships. 

In this article, we discuss some of the specific challenges that present with each type of treatment and the socio-physical impact they have on survivorship. Among the most detrimental to sexual function, are the use of chemotherapy and endocrine therapy. Additionally, anatomical changes that transpire in patients who have undergone surgery or radiation therapy (RT), disrupt perceptions of body image. Here we will discuss and also review the contemporary literature to determine effective management and treatment of sexual dysfunction.

Below:  Sexual health in women

Clinical trials of interventions in breast cancer survivors

Intervention	N	Trial	Results
Topical testosterone (25)	21	Phase I/II	Significant improvement in dyspareunia and dryness
Transdermal testosterone (26)	150	RCT	Compared to placebo, no difference in sexual function scores at 4 or 8 weeks of intervention
Vaginal dehydroepiandrosterone (33)	441*	RCT	Compared to placebo, improvement in sexual satisfaction scores
Aqueous 4% lidocaine (30,31)	49	RCT	Compared to normal saline, significant improvement in pain; resumption of sexual intercourse in 17 of 20 women who had previously abstained
Vaginal pH-balanced gel (28)	86	RCT	Compared to placebo, nonsignificant improvement in vaginal dryness and dyspareunia
Polycarbophil-based vaginal moisturizer (29)	45	RCT	Compared to placebo, trend towards improved dyspareunia scores. Both groups had improvement in average vaginal dryness

RCT, randomized controlled trial. *, breast and gynecologic cancer survivors included in this study.

Full article at:   http://goo.gl/MMyGHu

By:  Boswell EN1, Dizon DS1.

• 1 Dana-Farber Cancer Institute, 2 The Oncology Sexual Health Program, The Massachusetts General Hospital Cancer Center, Boston, MA 06114, USA.
• Transl Androl Urol. 2015 Apr;4(2):160-8. doi: 10.3978/j.issn.2223-4683.2014.12.04. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health