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Hope for Vaginal Dryness

Posted 1/7/2016

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  Sexuality and intimacy are important issues and often impacted by cancer treatment. Clearly a sexual relationship is a complicated mixture of psychological and physical factors, hopefully woven together with tenderness and love. I am writing today about the physical issues and a recent hopeful study for a problem that many women experience after cancer.

  We all know that natural menopause greatly reduces the estrogen in a woman's body, and that has many implications--one of which is vaginal dryness that can range from mildly problematic to painful to an absolute ending of intercourse due to pain. Of course this happens to women who have not had cancer, but they are generally able to use various herbal supplements (that work because they are plant estrogens) or topical estrogen, or the Estring.

  For women with a cancer, generally an ER positive breast cancer, history, this is problematic. Part of their staying healthy may depend on keeping as much estrogen as possible out of their bodies, so many oncologists are wary of these products. It is always an individual decision, a talk to your doctor moment, and some women choose to take the small associated risk to achieve a larger benefit. Although any topical estrogen cream or the Estring introduces a very small amount of estrogen, only what is absorbed through the vaginal wall, it is still a consideration to be taken seriously.

  Now a new study from Canada suggests that another hormone, not estrogen, called DHEA may provide the same result. Note that women with a cancer history were excluded from this preliminary study, so the jury is still out, and it is still a talk with your doctor issue. Here is the start of an article from Medscape and a link to read more:

Intravaginal DHEA Eases Postmenopausal Vaginal Dryness,Pain
Marcia Frellick

Positive results from a phase 3 trial of intravaginal dehydroepiandrosterone (DHEA; EndoCeutics) suggest it may be a viable alternative to intravaginal estrogen in combatting dryness and painful sex after menopause.
"The fact that we would have another new hormonal treatment that is not estrogen is exciting," JoAnn Pinkerton, MD, NCMP, executive director of the North American Menopause Society, told Medscape Medical News. "And unlike lubricants and moisturizers, it actually corrects the problem. For women who are fearful of or don't want to use vaginal
estrogens, it gives them a hormonal vaginal product that works." DHEA is a hormone, but the effects appear to be localized, which means no significant amount of sex hormone gets released into the bloodstream. All estrogen-based vaginal formulations increase estrogens in the bloodstream, even at low doses, say lead author Fernand Labrie, MD, PhD, president and chief executive officer of EndoCeutics Inc, Quebec
City, Quebec, Canada, and colleagues.
Findings of the study, funded by EndoCeutics, were published online December 28, 2015, in Menopause. In an earlier interview with Reuters Health, Dr Labrie said he expects approval by the US Food and Drug Administration this year.

http://www.medscape.com/viewarticle/856796_print

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