Breast Cancer Survivors and Low Sexual Desire
Claudia Panzer, M.D., an endocrinologist from Denver, was a presenter at the International Society for the Study of Women's Sexual Health (ISSWSH) . She covered several topics that were relevant to my therapy practice -- among them was breast cancer.
Between my clients and personal friends, I know a lot of women affected by breast cancer. Most of the treatments that keep them alive turn out to be quite devastating to their sexual interest. So, what can be done?
For those women who wish to have a quality of life that includes sexuality, testosterone supplementation has some good potential. Panzer cited studies that addressed the concerns that many women have: Will I feel more like having sex? Will it cause my cancer to return?
Supplementing with a transdermal testosterone gel product like Androgel or Testim (both off-label use) can raise total testosterone levels and free testosterone levels. These can increase libido. Not all women will find this effect, but many do. Of course, depression needs to be addressed in these situations because women with cancer may feel depressed. Testosterone itself may not be sufficient to alleviate the depression and the use of an antidepressant may be helpful. (There can be side effects of SSRI-type antidepressants that are negative for sexuality, but that is another blog post.)
So, what do the studies show?
Women who have PCOS (polycystic ovarian syndrome) have rather high levels of testosterone, but they have no higher occurrence of breast cancer than other women.
When the breast tissue of transsexuals (females changing into males) is examined after a mastectomy, their tissue is comparable to women who have breast reduction surgery. Of course, these transsexuals would have much, much higher levels of testosterone (as an early part of their treatment), but their histology (how the tissue looks under a microscope) is similar to women with "female" (much lower) levels of testosterone.
A study by Adelaide (Dimitrakakis, Menopause 11:531, 2004) showed that women who used estrogen and testosterone had only 115 cases of breast cancer per 100,000 women years while women who never used it had 283 cases.
Panzer summarized her findings (and I am only mentioning a few here) by stating that there is no evidence of increase of breast cancer with use of testosterone supplementation and that it may be protective when low doses that are effective are used . The risk of negative side effects (facial hair growth, deepening of voice, acne, etc.) is low and they are reversible by simply reducing the dose of testosterone. She also stated that liver function, sleep apnea, and aggression in women are "non-issues."
Low sexual desire is a common problem in breast cancer survivors, but there are choices that women can make to promote greater sexual interest if they wish. I know some women who will be glad to hear that.
Related Topics:
Between my clients and personal friends, I know a lot of women affected by breast cancer. Most of the treatments that keep them alive turn out to be quite devastating to their sexual interest. So, what can be done?
For those women who wish to have a quality of life that includes sexuality, testosterone supplementation has some good potential. Panzer cited studies that addressed the concerns that many women have: Will I feel more like having sex? Will it cause my cancer to return?
Supplementing with a transdermal testosterone gel product like Androgel or Testim (both off-label use) can raise total testosterone levels and free testosterone levels. These can increase libido. Not all women will find this effect, but many do. Of course, depression needs to be addressed in these situations because women with cancer may feel depressed. Testosterone itself may not be sufficient to alleviate the depression and the use of an antidepressant may be helpful. (There can be side effects of SSRI-type antidepressants that are negative for sexuality, but that is another blog post.)
So, what do the studies show?
Women who have PCOS (polycystic ovarian syndrome) have rather high levels of testosterone, but they have no higher occurrence of breast cancer than other women.
When the breast tissue of transsexuals (females changing into males) is examined after a mastectomy, their tissue is comparable to women who have breast reduction surgery. Of course, these transsexuals would have much, much higher levels of testosterone (as an early part of their treatment), but their histology (how the tissue looks under a microscope) is similar to women with "female" (much lower) levels of testosterone.
A study by Adelaide (Dimitrakakis, Menopause 11:531, 2004) showed that women who used estrogen and testosterone had only 115 cases of breast cancer per 100,000 women years while women who never used it had 283 cases.
Panzer summarized her findings (and I am only mentioning a few here) by stating that there is no evidence of increase of breast cancer with use of testosterone supplementation and that it may be protective when low doses that are effective are used . The risk of negative side effects (facial hair growth, deepening of voice, acne, etc.) is low and they are reversible by simply reducing the dose of testosterone. She also stated that liver function, sleep apnea, and aggression in women are "non-issues."
Low sexual desire is a common problem in breast cancer survivors, but there are choices that women can make to promote greater sexual interest if they wish. I know some women who will be glad to hear that.
Related Topics:
- Breast Cancer Survivors: A Return to Sex and Intimacy
- Breast Cancer Survivors: Life After the Treatments End
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