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Sex Complaints Common After Breast Cancer

Mastectomy, Aromatase Inhibitors Linked to Sexual Dysfunction
WebMD Health News
Reviewed by Laura J. Martin, MD

Sept. 23, 2010 -- Loss of libido and difficulty having sex are common complaints among breast cancer survivors, new research confirms.

More than two-thirds of surveyed survivors reported that they were still having sexual function problems two years after diagnosis. Most described their sex lives as satisfying before breast cancer.

Women taking aromatase inhibitors as treatment for their breast cancer reported more sexual problems than women taking tamoxifen.

Body image issues and vaginal dryness related to aromatase inhibitor use were among the most frequently mentioned complaints.

“Sexual problems are among the most common and least talked about side effects of breast cancer treatment,” study co-author Susan R. Davis, MD, of Victoria, Australia’s Monash University Medical School tells WebMD.

“About 70% of the women in our study were experiencing a meaningful loss of desire and sexual function a full two years after diagnosis.”

Sex After Breast Cancer

Gynecologist and breast cancer survivor Melanie Bone is surprised the number isn’t 100%. Bone, who practices in West Palm Beach, Fla., had a double mastectomy 10 years ago at age 40.

She says her breast cancer was the nail in the coffin of an already strained marriage. Even though she is now happily remarried, Bone acknowledges that she is still having issues related to sexual function.

“From the moment the surgeon takes a knife to your breast -- unless you have superhuman self-esteem -- there is an impact on sexuality,” she tells WebMD.

Even women who have breast-sparing surgery may no longer enjoy having their breasts touched during sex because it reminds them of their cancer and treatment.

“Many of the breast cancer survivors I treat tell me their foreplay no longer involves the breasts,” she says.

The issue of pain related to vaginal dryness during sex may be more easily addressed.

About three out of four breast cancer tumors are estrogen-receptor (ER) positive, meaning that they grow when exposed to the female sex hormone.

These days, nearly all women with ER-positive tumors take estrogen-blocking drugs such as tamoxifen or aromatase inhibitors for several years following initial treatment.

Although tamoxifen can actually cause an increase in vaginal secretions in some women, use of aromatase inhibitors almost always results in extreme vaginal dryness related to estrogen depletion, which can make sex extremely painful.

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