Breast Cancer Treatment and Post Menopause

Women treated for breast cancer after menopause with aromatase inhibitors have very high levels of sexual difficulties, including low interest, insufficient lubrication, and pain with intercourse. It is an important and underestimated problem.

The treatment of breast cancer has great impact on specific aspects of sexuality in postmenopausal women. Nearly three quarters of women with breast cancer have insufficient lubrication, more than half have pain with intercourse.  Majority of them say their sexual interest is low and most of them are dissatisfied with their sex life.   Although women taking tamoxifen for breast cancer also have low sexual interest and more pain with intercourse, they had significantly fewer difficulties than women taking aromatase inhibitors.

The drug, aromatase inhibitors stops production of estrogen in postmenopausal women and therefore makes less estrogen available to stimulate the growth of certain breast cancer cells. Many postmenopausal women with breast cancer are routinely treated for several years with these potentially life-saving drug, which can cause bone loss and fractures. Bone loss from aromatase inhibitors can be prevented long term with a safe and effective drug that prevents osteoporosis.

Aromatase inhibitors, which block formation of estrogen from other hormones in the body, may offer advantages in terms of preventing breast cancer recurrence and possibly in increasing survival, so they may be used more in the future. Unfortunately, effective treatment options for their sexual side effects are lacking, because too much estrogen may be absorbed from vaginal estrogen treatments.

Vasomotor symptoms are menopausal symptoms such as hot flushes and night sweats. Adjuvant endocrine therapy describes the treatment of hormone receptor positive breast cancer with additional hormone drugs, after surgery and radiotherapy, in order to help stop the disease from coming back.

Women with sexual problems have concerns about their body image after breast cancer. Also, specific treatments for breast cancer are more likely to be associated with menopausal symptoms, which can contribute to sexual problems.

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