More on Sexuality
Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work
MARCH 22, 2017
Actually today's entry is more specific, but a general title seemed more likely to attract interest. Many women after menopause struggle with the unfortunately-named vaginal atrophy. This describes the thinning of the vaginal wall that can result in less lubrication and more discomfort/pain with intercourse. Women who don't have a cancer history have more options in dealing with this than we do. The cancer catch, once again, is estrogen. Estrogen can play a role in breast cancer and some GYN cancers, and many women post cancer treatment are on estrogen-suppressing drugs (think tamoxifen or the AIs).
Periodically there are studies about possible hormonal treatments for vaginal atrophy, but they tend to be vague or non-conclusive or recommend more studies. It always comes down to "talk with your doctor about your particular situation". And then it even more comes down to your comfort with taking a possible health risk to improve your QOL.
Hormonal Products for Vaginal Atrophy on AI: 'Murky Waters'
Postmenopausal women taking aromatase inhibitors (AIs) for their early-stage, hormone receptor–positive breast cancer can safely use vaginal estrogen or testosterone to relieve urogenital atrophy, according to the authors of a new study published in JAMA Oncology.
But these study authors are venturing into "already somewhat murky waters," suggested the coauthor of an accompanying editorial. "I don't know if their definition of safety is correct," commented Hyman B. Muss, MD, from the University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, in an interview with Medscape Medical News. "I'm still worried about the safety of both of these approaches."
"I think it's a small study with short follow-up. I suspect it will turn out to be safe, but I'm not sure," he continued. "It's likely to turn out to be a minimal risk, but it's going to take a huge number of patients with long-term follow-up to know that, and I doubt we'll see anything convincing for many years."
The randomized, noncomparative, single-institution, phase 2 trial included just 76 postmenopausal women with stage I to III hormone receptor–positive breast cancer.
All had been treated for at least 30 days with AIs and had reported vaginal dryness, dyspareunia, or decreased libido.