Sex Complaints Common After Breast Cancer
Mastectomy, Aromatase Inhibitors Linked to Sexual Dysfunction
Effective Libido Drugs Needed
In the study, which included nearly 1,600 breast cancer survivors with sexual partners recruited within a year of their cancer diagnosis, use of aromatase inhibitors was associated with a more than three-fold increased incidence of sexual function problems.
“Every woman who is put on these drugs should be told it is highly likely they will experience symptoms related to menopause, including vaginal dryness, but that isn’t always happening,” Davis says. “And women may be reluctant to talk about the issue with their oncologist.”
Bone recommends topical vaginal estrogen to many of her breast cancer patients.
Although this is somewhat controversial, she says the doses used in most estrogen-containing vaginal creams are very low, and studies show that very little is absorbed systemically.
Davis recommends starting with a non-hormonal lubricant like vegetable oil.
The survey revealed that women who had their breasts removed were twice as likely to report negative feelings about body image as women who had breast-conserving surgeries, even when they had breast reconstruction surgery.
“Reconstruction is major cosmetic surgery and a lot of women end up with pain,” she says.
She says the high incidence of low desire among women who have been treated for breast cancer speaks to the need for effective libido-targeting treatments.
Early last summer, an FDA panel recommended against approval of the drug flibanserin, which has been called the ‘female Viagra,’ concluding that two studies failed to show a significant increase in desire among women taking the drug compared to women taking placebo pills.
“I think this drug needs to be studied in women with breast cancer because it is non-hormonal and this is a population with a real need for a libido drug,” she says. “And you are not likely to see a big placebo effect. If it doesn’t work, they will tell you.”