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Subscribe to RSSWomen treated with hormone-blocking drugs to stave off breast cancer recurrences are often dissatisfied with their sex lives, a new study from Sweden has found.
More than half of older women treated with so-called aromatase inhibitors said sex was almost always painful and they frequently had "insufficient lubrication," researchers reported in the journal Menopause.
In contrast, less than one-third of women on tamoxifen, another anti-estrogen drug, reported painful sex.
"We've suspected that the aromatase inhibitors would be more likely to cause sexual dysfunction for quite a while," said Dr. Don Dizon, a gynecologic oncologist from Massachusetts General Hospital in Boston who has studied sexual health in cancer survivors.
Those drugs, he said, block women's bodies from producing estrogen. Tamoxifen, on the other hand, just stops the hormone from acting on cells in the breast. Both can be prescribed to women with hormone receptor positive breast cancer, the most common type.
Dizon said it stands to reason that without any estrogen production, women could see their sex lives suffer. But most don't mention those problems to their doctors, and many oncologists feel uncomfortable discussing sexual health, he told Reuters Health.
For the new study, researchers surveyed 82 women who'd had breast cancer and were taking aromatase inhibitors or tamoxifen to prevent the cancer from coming back. The women were all between 55 and 70 years old, and had been diagnosed two to six years earlier.
Dr. Juliane Baumgart of Orebro University Hospital and colleagues compared those women's responses to sexual health surveys from 102 women of the same age who hadn't had breast cancer.
Most women in both the cancer and non-cancer groups said they were sexually active.
Among those having sex, 74 percent of women taking aromatase inhibitors said they always or almost always had trouble with lubrication, compared to 40 to 42 percent of women who hadn't had breast cancer or those who were treated with tamoxifen.
Painful sex was reported by 57 percent of sexually active women on aromatase inhibitors, compared to 31 percent on tamoxifen and 21 percent or less in the comparison group.
There was not a substantial difference across groups in how many women reported trouble reaching orgasm, but more women taking aromatase inhibitors said they were generally dissatisfied with their sex lives.
Dizon, who wasn't involved in the new study, said it helps illustrate the different ways sexual health may be affected for women on aromatase inhibitors. Most women in the U.S. who get breast cancer after menopause are treated with a five-year course of those drugs, he said.
Oncologists at the very least should be ready to point women to resources where they can get help for sexual problems, according to Dizon.
He tells patients that using vaginal moisturizers and water- or silicone-based lubricants may help alleviate pain during sex. In addition, Dizon said he emphasizes the importance of intimacy in relationships.
"As women get treated for cancer we need to think about the toxicities and the long-term side effects, and sexual health is one of those areas that is really important," he said.
"The notion from an oncologist that you're just lucky to be alive is not acceptable."
SOURCE: http://bit.ly/Uyc8mn Menopause, online September 17, 2012.
Copyright 2013 Thomson Reuters. Click for restrictions.
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Small price to pay for your health. Sex isn't very good when you're dead either. Not a difficult choice to make.
Bloggette, What an incredibly insensitive thing to say. No choices during breast cancer treatment are easy. Everything feels like a loss: loss of a breast, loss of confidence in your health, loss of time with your family & friends, loss of control, loss of your youth, your hair, your sexuality, your ability to have children, etc... Many, many women and men, of all ages, are surviving breast cancer today, and to tell them that they should be happy to live asexual lives and just be thankful they are not dead is cruel. I feel appreciative of the researchers who choose to study these drugs and make recommendations on how cancer survivors can reach for an improved quality of life.
I am so curious as to whether Bloggette is a survivor. If you are, perhaps what you have gone through has turned you into such a thoughtless and cruel person. If you are not a survivor, then you should not comment about what you have not experienced or know. I am a two-year survivor who had my ovaries out as part of my treatment and am on an aromatase inhibitor. "Sexual dysfunction" is now a part of my life that I have to deal w/ every single day. Of course I would choose life over sex, but it is not okay to diminish issues that so many of us face because of the fight we put up every day to help cancer from coming back. No one chooses cancer or anything that comes along with it.
My mother was just recently diagnosed with this specific form of breast cancer (a single tumor in both breasts) and is on the Tamoxifin. I have to agree with blogette here to a certain extent...take your choice. Sex isn't required in order to live; the medications are. If a person has to give up, temporarily, some things in order to survive, I would say it is a good sacrifice.
This particular form of breast cancer is nearly 100% curable at this point with the proper meds and my mother's oncologist indicated that the tumors associated with this type of breast cancer often fade away completely without invasive surgery or a loss of the breast(s) and often in less time than a year.
Well now, there a choice nobody wants to make -- death by breast cancer or a lively sex life. ACK!
"Dizon said he emphasizes the importance of intimacy in relationships."
What about the importance of the woman's health in the "intimacy in relationships"? Having sex when she has cancer should be the last thing on his mind. Her well-being should come first. If it doesn't, then there is no intimacy in the relationship.
Walk a mile in my shoes. As 2 time cancer survivor who has had to deal with the post chemo sexual problems that nobody wants to talk about, there are some very callous remarks posted here. It shouldn't have to be about a choice between life and quality of life. We aren't stupid, obviously we are going to chose to live before all else. But to make light of the fact that you suddenly no longer have the same intimacy with your spouse/partner as you did before is wrong. It is a devastating feeling. Don't presume its as simple as sex isn't required to live. Most of us have already lost our breasts which is devastating enough. That loss of intimacy with no real help for it, is equally as devastating. Until you have gone through it yourself, please think before you comment.
Total control must be vested in the woman who is the patient. That control should not be ceded to doctor, husband or lover. She is the person who has to live with the result, so she should be fully informed of all benefits and adverse side effects -- and then given the time to consult with others (including a second doctor), to do research and accomplish whatever else she needs to be sure her decision is the best one for her in the circumstances. Even after consulting with others, the final decision should be hers and should be supported by all who care about her.
She and she alone should decide how much weight to give to the various treatments vs. her future sex life. She should not be pressured one way or the other by her doctor or her intimate partner.
Thank you BCSurvivor55! I am right there with you. I am a 11 year survivor and we olny 30 when diagnosed. I have a wonderful loving husband and understand exactly what you are saying. I wish I would have at least been told this was going to happen...at least then I could have talked over my options with my doctor....not just given the drug and then told after the fact when I asked why I was having the issues. Oh...sorry there is nothing really that helps with that.
Tamoxifin can also be prescribed for patients who do not have cancer but are at a higher risk because of family history. It is important that patients be told that 30% will experience this side effect so they can make an informed decision. I went on the medication for only six months and I have had this negative side effect for several years. I never would have agreed to this had I known. I am thankful I have a very understanding husband.
Toxicities and long term side effects of cancer treatments need to be addressed in ALL areas of health, not just sexual health. This makes headlines because anything that can use the word 'sex' is going to get readers, but the real issue is cancer treatments often do more to harm patients in the long run than help them. As long as Big Pharma is making loads of money on chemo, there won't ever be a viable cure that doesn't ending up torturing a patient and ultimately making their remaining time miserable.