- Question from I Sing For You: What do you recommend for low libido? I was perimenopausal before chemo, but that ended my sex life. I have no libido, and my vagina is dry and shrunk. It has been almost 6 years.
- Answers - Debra Barton Those are actually two different problems. The dry vagina is one issue; the low libido is another, related issue. When we are talking about non-estrogen alternatives to manage these things, the problems actually take different solutions. For libido, there are lots of behavioral things to do. For instance, pay attention to lighting, mood, candles, how you feel about yourself, preparing for your time with your partner. All the things that when we were younger we took for granted, may take a little extra planning and forethought. That's Number 1. I encourage women not to underestimate that part--it really can set the stage and help increase libido. From a medication standpoint, the one medication that has been tested not in women with a history of breast cancer, but in women with libido problems and with arousal disorders, has been testosterone. There are some new testosterone patches and a gel that are available. There are health care providers that have some experience with these. The studies in the dose and type of testosterone that are needed to increase libido in women with a history of breast cancer have not yet been done.
- Charles Loprinzi With regard to the vaginal dryness, there are some things that can be done. There are non-hormonal agents such as Replens and many others that can help a little bit. Local use of estrogen also can be helpful. Either something like a Premarin vaginal cream or something called Estring, which is a ring that is placed in the vagina for a period of time (3 months), can be utilized. There are some concerns which patients and physicians may raise with regard to this use of estrogen, because there is a little bit of systemic absorption with these delivery means, but most physicians are comfortable with this local use of estrogen.
- Jennifer Griggs, M.D., M.P.H. The absorption into the system is early on when the vaginal wall is thin, but as the vaginal wall responds to the local estrogen, absorption goes down.
- Charles Loprinzi Because it becomes thicker.
- Debra Barton Something to keep in mind regarding vaginal dryness is that the more intercourse a woman has, the more blood flows to the tissues, and the healthier the tissues will remain.
- Jennifer Griggs, M.D., M.P.H. Interested women may want to read last month's chat on the topic of sexuality after breast cancer.
The Ask-the-Expert Online Conference called Managing Menopausal Symptoms featured Charles Loprinzi, M.D., Debra Barton, Ph.D., and Jennifer Griggs, M.D., M.P.H. answering your questions about hot flashes, vaginal dryness, loss of libido, and other symptoms associated with menopause.
Editor's Note: This conference took place in March 2002.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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