Sexual wellbeing after breast cancer study

Most women with invasive breast cancer have hormone sensitive tumours and are treated with an aromatase inhibitor or tamoxifen. Increasingly women are receiving more than five years of this treatment.

Aromatase inhibitors work by blocking the production of estrogen throughout a woman’s body, therefore depriving any remaining breast cancer cells of estrogen. A little talked about side-effect, common among postmenopausal women with hormone sensitive breast cancer taking an aromatase inhibitor is vaginal dryness, irritation, painful sex and urinary tract problems.

These symptoms can be very severe, and lead to avoidance of sexual activity and relationship distress. As a result, some women stop taking their aromatase inhibitor, and this increases the risk of a relapse.

Although low dose vaginal estrogen, which is the standard treatment for these vaginal symptoms, is sometimes used by women in this setting, it would be highly preferable to be able to offer women an effective non-estrogen alternative.

There is some evidence that a low dose of vaginal testosterone cream might be effective and safe for women taking an aromatase inhibitor.

Professor Susan Davis and her team will conduct a trial to evaluate the effectiveness and safety of intra-vaginal testosterone therapy in women taking an aromatase inhibitor and determine their level of sexual satisfaction and function, as well as objective and subjective measures of vaginal health and urinary incontinence.

This study has the potential to improve the wellbeing and quality of life of a large proportion of women who have had breast cancer. This extends beyond individual women to include their intimate partners and contributing to domestic wellbeing.

Professor Davis hopes that information about the study will facilitate discussion about vaginal and urinary tract issues and will de-stigmatise the intimate issues and encourage affected women to seek help and feel more able to discuss their symptoms with their partner.