After Breast Cancer: Improving Your Sex Life
Healthy Women Informed, Empowered
What pharmacologic interventions can improve sexual function?
Some patients complain of having a low libido and changes in orgasm or arousal. Sexual pain disorders like dyspareunia (pain during intercourse) and vaginismus (reflexive contracture and tightening of the pelvic and vaginal muscles) are also prevalent. Discuss your sexual concerns with your healthcare providers. Specialists are available who focus on the oncological patient and sexual functioning.
A sexual healthcare provider will get a medical and gynecological history, a comprehensive general physical and genital examination, and a psychological as well as psychosexual examination. A complete medical and obstetrical history may provide some clues about the origin of the sexual complaint. Medications, including dose, time of day for administration, and possible side effects, will be discussed. Also, complementary and alternative therapies should also be discussed. Give your provider a list of prescription and over-the-counter medications you are taking, including supplements and vitamins.
Laboratory tests, such as a blood laboratory of various hormones or radiological evaluation, may be appropriate. Sometimes hormones or thyroid function is measured. Glucose and lipid function/cholesterol may also be assessed.
A sexual history will include sexual status, orientation, and past sexual experience; these concerns are important to discuss. Patients may also be encouraged to see a sexual medicine specialist/gynecologist and or a certified counselor or therapist for initial evaluations and follow-up. Because sexual dysfunction is often complex and multidimensional, an individual’s treatment may involve several different approaches. Healthy, satisfying sexual functioning and treatment success are impacted by a variety of factors, including medical illnesses, hormonal levels, relationship concerns, partner availability, underlying psychiatric disorders, general medical well-being, and cultural and religious behaviors.
Do many cancer survivors experience sexual complaints?
According to recent statistics from the American Cancer Society, with technological treatments and advancements in diagnostics and therapeutics, an estimated 60% of cancer survivors will live at least 5 years after their diagnosis. In 2009, over 11 million people were cancer survivors in the United States. Sexual complaints occur in up to 90% of women who have been diagnosed with cancer, and the number of women with post treatment sexual dysfunction range from 30% to 100%. Unfortunately, these sexual complaints—lowered interest, vaginal discomfort, or pain-persist for many years, but are common and treatable conditions. There is no need to suffer in silence. You are not alone if you have some sexual complaints. You may feel embarrassed or ashamed to discuss the issues with your healthcare providers. Nevertheless, your provider should be receptive to helping you with these deeply private issues. However, if your healthcare provider is uncomfortable or does not have the skills to deal with these sexual concerns, do not get discouraged. Do not give up!
What specific sexual health management therapies can I expect?
Listed here are a variety of therapeutic options that the sexual medicine specialist may perform in order to treat your sexual complaints effectively.
Treatment of systemic illnesses. Cancer survivors often have other underlying medical conditions and illnesses that directly impact their sexual health. Evaluation and treatment of chronic illnesses, such as uncontrolled hypertension, hypercholesterolemia, and/or an underlying thyroid dysfunction, can be simple to identify. Arthritis or lymphedema from surgery or therapy may impact your finding comfortable sexual positions. Uncontrolled diabetes may influence veins, arteries, and nerves in the genital pelvic region, impacting blood flow and directly affect excitement. Underlying genital infections like candida (yeast), bacterial vaginitis, and trichomoniasis should be effectively treated. Often, sexual specialists include screening, such as a complete blood profile, to rule out anemia, complete lipid profiles, glucose screening, and prolactin levels. Estrogen, testosterone, adrenal hormones, as well as progesterone and other hormonal profiles, are typically measured. In the acute crisis of cancer care, pre-existing medical illnesses can sometimes be neglected. In long-term follow-up, however, treating any underlying chronic medical illnesses improves your general physical and mental well-being, as well as your sexuality.
• Medications. Most medications can affect the female sexual response cycle and cause sexual problems. Antidepressants and antihypertensive medications can change sexual desire, arousal, and orgasm. Ask your healthcare provider to check pharmacologic guides to identify potential offending agents and consider substituting another less offensive drug. Sexual pharmacology textbooks and the Internet provide a quick reference. Some over-the-counter medications-like allergy medicines-can cause or exacerbate vaginal dryness. The medical treatment of sexual dysfunction often includes changing medication
regimens, altering dosing and/or time intervals, or switching to a new drug. You should never abruptly stop any prescribed medication without first consulting with your prescribing provider. Some recent medical studies show that women who suffer from sexual dysfunction as a result of their antidepressant medications (like serotonin reuptake inhibitors) may benefit from phosphodiesterase inhibitors such as Viagra Sildenafil (Pfizer), Cialis Tadalafil (Lilly ICOS), or Levitra (Vardenafil) (Bayer Pharmaceutical and GlaxoSmithKlein).
Terms:
Dyspareunia – Painful intercourse.
Vaginismus – An involuntary tightening of the vaginal muscles when the vagina is penetrated. The action can cause significant distress and pain
Hypercholesterolemia – The presence of an abnormal amount of cholesterol in the cells and plasma of the blood.
Candida – Yeast infection typically occurs in the vagina and can be associated with itchiness and vaginal discharge.
Vaginitis – Inflammation of the vagina.
Trichomoniasis – A common sexually transmitted disease caused by the parasite Trichomonas vaginalisand infecting the urinary tract or vagina.
Phosphodiesterase inhibitors – Drugs that block one or more of the five subtypes of the enzyme phosphodiesterase (PDE ), therefore preventing the inactivation of the intracellular second messengers cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) by the respective PDE subtype(s).
Sildenafil – A phosphodiesterase inhibitor that is traditionally used in the treatment of male erectile dysfunction. New data support this class of medication that can sometimes be used for the treatment of SSRI – induced female sexual problems.
You are not alone if you have some sexual complaints.
A well-balanced, nutritious diet combined with an active aerobic exercise plan is vital.
