Breast Cancer Drugs: Preventing Cancer (and Sex, Too)
The national media are jumping all over a recent Swedish study revealing that the long-term drugs many survivors take to help prevent a recurrence of their cancer also prevent something else: a satisfying sex life. Gee, thanks for the info.; now what can we do about it?
If you’ve been treated for hormone-receptive breast cancer, you’ve almost certainly been prescribed a 5- to 10-year follow-up course of one or a combination of several drugs: tamoxifen, or an aromatase inhibitor (AI): Arimidex, Aromasin, or Femara.
And if you’re an engaged (or even curious) patient, you’ve no doubt read the long, sad litany of the possible side effects accompanying these drugs: headaches, endometrial cancer, joint pain, stroke, hot flashes, cataracts, insomnia, weight gain, vaginal dryness…
A few of these sound like menopause, don’t they? You’re right. Menopause and these particular cancer drugs have a common result: they reduce the effects of estrogen in your body, both positive, and negative.
Beginning during menopause, your body produces a lot less estrogen. But even if you haven’t been through menopause, tamoxifen prevents your system from absorbing estrogen. And if you’re post-menopausal, AIs prevent your body from converting other types of hormones (e.g., androgen) to estrogen.
When you’re on hormone therapy for breast cancer, your body is really, REALLY starved for estrogen. Good if you’re looking to stay cancer-free; but bad in a number of other ways, including those irritating hot flashes, weight gain, and vaginal dryness.
Vaginal dryness. Does that mean…?
Yes, that’s exactly what it means. Vaginal dryness, as in insufficient lubrication, as in… ouch. Make that a BIG ouch, in many cases. Vaginal dryness, combined with a thinning of the vaginal wall (another side effect of estrogen starvation), can translate to very painful sex.
Remember your first time? That kind of pain.
So, here’s the deal: Swedish researchers studied a small group of women and concluded that nearly half of women taking hormone therapy drugs were dissatisfied with their sex life; and over half taking an AI (and nearly a third on tamoxifen) reported painful intercourse.
Results of the study, which appeared last week in Menopause, the journal of the North American Menopause Society, include this little nugget: “Our findings suggest that sexual dysfunction in aromatase inhibitor-treated women is a greatly underestimated problem.”
It’s the problem women least like to talk about – to their doctors. There’s plenty of buzz about bad sex in the survivor community, but women bringing it up to their oncologist most often get one of two responses:
A. “Staying alive is our first goal here. Your sex life is a secondary consideration. ”
B. “I’m really sorry; I wish there was something we could do, but there just isn’t.”
Meanwhile, women in their 40s and right on up find themselves deprived of one of life’s great (free) pleasures: enjoyable sex.
Is there truly nothing anyone can do?
Well… depends on your capacity for risk. Adding a little bit of estrogen back to your body, in the form of a topical cream (e.g., Premarin), can partially restore your vagina to its former healthy state – thus reducing the pain of intercourse.
Will that estrogen cream increase your risk of recurrence at the same time it’s increasing your sexual pleasure?
No one knows for sure.
But if you believe there’s more to life than simply “being alive”, it might be a risk you’re willing to take.
Moore, A. (2012, September 29). Breast cancer drug negatively affects sex life. Retrieved from http://www.medicaldaily.com/articles/12419/20120929/breast-cancer-drug-negatively-affects-sex-life.htm