I see many women who are cancer survivors. Most of them feel that their post cancer sexual selves were never addressed. In fact, many were told, “you should be happy to be alive”, insinuating that they should stop focusing on any sexual dysfunction caused by cancer treatment. It is often very upsetting for them to have this important aspect of who they are dismissed. It seems particularly frustrating to me because there is so much we can do to bring back their sexual functioning. These women most often complain of low libido, vaginal dryness and pain with penetration.
A great new article just came out in the Huffington Post, by Linda Dyett, titled “Should Women Consider Taking Testosterone.” The article addressed many important issues, one of which is should women use testosterone to address low libido. “Women, before, during and past menopause, and sometimes as early as in their mid-30s, invariably have low testosterone levels,” Glaser says. “Not all of them will experience its wide variety of symptoms, like low libido, hot flashes, fatigue, mental fogginess and weight gain. For those who do, and who seek to avoid taking synthetic oral hormones (shown by National Institutes of Health findings to pose an increased risk for breast cancer, heart attack, stroke, blood clots and dementia), bioidentical testosterone (whose molecular structure is the same as natural testosterone) has been shown to be safe and effective. Some testosterone is converted by the body into estrogen — which partly explains why it is useful in treating menopausal symptoms. For those at high risk for breast cancer, or who have had it, that conversion can be prevented by combining testosterone with anastrozole — an aromatase inhibitor that prevents conversion to estrogen. Nonetheless, testosterone has been shown to be beneficial for patients with breast cancer. Preliminary data presented at the American Society of Clinical Oncology has shown that, in combination with anastrozole, testosterone was effective in treating symptoms of hormone deficiency in breast cancer survivors, without an increased risk of blood clots, strokes or other side effects of the more widely used oral estrogen-receptor modulators tamoxifen and raloxifene.” It is so important that this information be disseminated so that women no longer feel as though their concerns are being dismissed or that they must suffer through these symptoms silently.
Vaginal health and painful intercourse are two other areas that can be addressed. Vaginal dryness is something many women suffer from and there are vaginal moisturizers and topical creams that successfully treat the vaginal tissue. If a woman is suffering from painful intercourse, dilators can be used to stretch the vaginal tissue and then normal sexual activity can be resumed. These are not easy things to discuss and many providers don’t know how to help. If you or someone you know is going through this, reach out. It is obviously enormously difficult to go through cancer and everyone goes through the experience differently. The women that sit across from me often express that they want the ability to connect with their partners in the way they did before cancer and I love that we can help with that process.