Women with breast cancer are known to have better cancer-related outcomes when they receive aromatase inhibitors (AIs). However, the treatment can lead to challenges in sexual function because of the unpleasant vaginal and uro-genital symptoms.
A pilot study was conducted to assess the effects of using a daily vaginal testosterone cream on the sexual health and quality of life in women with breast cancer taking AI therapy.
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The study involved the participation of 13 postmenopausal women with breast cancer on AI therapy and showing symptoms of sexual dysfunction. The women were prescribed a 300 μg testosterone vaginal cream daily for four weeks. During the first study visit, a vaginal swab was obtained to rule out the presence of Candida species in participants.
Women with positive vaginal swabs were treated prior to starting the vaginal testosterone therapy. The main outcome measure of the study was to assess the impact of using vaginal testosterone cream on sexual health of the participants.
The participants were between the ages of 50 and 69, and all of them were married. Before enrolling in the study, 58 percent of participants had engaged in sexual intercourse within the past four weeks. After completing four weeks of vaginal testosterone therapy, 92 percent of participants had engaged in sexual intercourse. There were no participant reports of serious adverse events to the therapy.
Two of the participants shared their thoughts about participating in the study. One of them said that she had not informed her husband about the study because she did not want to raise his hopes. Another participant said that her husband did not know about the study, and she wanted to surprise him on Valentine’s Day.
All FSFI (Female Sexual Function Index) domain scores increased following the use of testosterone vaginal cream. The findings were statistically significant. The mean pre-treatment to post-treatment domain score increase was as follows:
Desire: 1.35 to 2.65 (P = 0)
Arousal: 1.2 to 2.83 (P = 0.002)
Lubrication: 1.18 to 2.68 (P = 0.018)
Orgasm: P = 0.005
Satisfaction: P = 0.001
Pain: P = 0
Total FSFI post-test scores improved for all participants when compared with baseline scores.
Testosterone is a key hormone for female sexual functioning because it facilitates sexual response through increase in blood flow, clitoral and vaginal engorgement, lubrication, and sensation. Available evidence suggests that the use of topical vaginal testosterone may be an appropriate alternative to vaginal estrogen treatment in women with breast cancer who receive AI therapy.
Research with regard to the use of testosterone replacement in women with breast cancer who take AIs is limited. The findings from this pilot study suggest the use of 300 μg testosterone vaginal cream daily for four weeks reduces unpleasant uro-genital and vaginal symptoms and improves related sexual health quality of life in women with breast cancer on AI therapy.
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