Breast Cancer Diagnosis & Treatment May Cause Sexual Dysfunction

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Among women who have survived breast cancer, difficulty during sex and a lack of libido are some of the most commonly heard complaints. Over two thirds of women surveyed said that they were still having some form of sexual dysfunction two years after their cancer diagnosis, and most of those reporting say that their sex lives were average or better before they got breast cancer. Women taking tamoxifen as a breast cancer treatment reported slightly fewer problems than those taking aromatase inhibitors, and vaginal dryness and body image issues were the most cited complaints.

The study’s co-author, Susan R. Davis of Australia’s Monash University Medical School, says that sexual problems are the side of breast cancer treatment that no one ever discusses. She adds that over 70% of the women in the study experienced a loss of sexual function and desire two years after their cancer diagnosis. However, breast cancer survivor Melanie Bone thinks the number is much higher.

Bone had a double mastectomy at age 40, and that her cancer diagnosis was the final straw in the breakup of her marriage. Bone is remarried now, but still has sexual issues. She says that the impact on sexuality and self-esteem begins the moment the surgery starts. Even women who have non-radical mastectomies may not want their breasts touched during intercourse, because it reminds them of all the pain and suffering they’ve been through.

The other main issue, dryness during sex, may be easier to fix. Roughly three out of four breast tumors are ER (estrogen receptor) positive, meaning that they grow when they are exposed to estrogen. Today, nearly all women with ER+ tumors take tamoxifen or aromatase inhibitors for years following their treatment. Though tamoxifen has been shown to increase vaginal lubrication in some women, aromatase inhibitors cause dryness and pain almost every time.

The study involved almost 1,600 survivors in relationships, having become involved in the study within a year of diagnosis. In study participants, aromatase inhibitor use meant a three-times-greater likelihood of sexual dysfunction. Some believe that every woman prescribed these drugs should be told that sexual symptoms are a possibility, and many women are very reluctant to bring their concerns to their oncologist.

For temporary relief, some doctors recommend a topical estrogen cream- a controversial recommendation- but most topical creams have a very low concentration of estrogen, meaning that little is absorbed. To be safer, women should start with a lubricant that contains no hormones.

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  1. Have any of these briliant researchers actually found a reason women who have had breast cancer surgery may experience some so called “sexual dysfunction” is far more simple than the the explanantions put forward here, such as having their breast touched reminding them of their surgery. Anyone who has scar tissue or significant slabs of flesh excised from their body can attest to plain old pain from the scar tissue and sensitivity to pressure being the reason they flinch when it is touched or compressed in any way. Women who have had breast conserving surgery as part of their breast cancer treatment are also supposed to have six monthly or annual mammograms for many years post surgery, which again involve exquisitely painful levels of compression of the affected breast, including dragging and wrenching of the scar tissue. I put forward the idea of sexual dysfunction related to the breast has more to do with plain, old fashioned pain than any psychological issues. These women should have been asked about how they coped with the compression of thier breasts from the ongoing mammogram surveillance ie., breast activity of a non-sexual natureto test the hypothesis. Unless someone is a dedicated masocist, pressure, tuggiing and maniulation of the affected breast, scar tissue and the excavated tumour bed is boody painful and the antithesis of pleasure!

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