Breast cancer, aromatase inhibitor therapy, and sexual functioning: a pilot study of the effects of vaginal testosterone therapy.

INTRODUCTION: Women with breast cancer have better cancer-related outcomes with the use of aromatase inhibitors (AIs), but the physiological suppression of estradiol can negatively affect sexual functioning because of unpleasant urogenital and vaginal symptoms. Local health care practitioners have observed that the benefits of vaginal testosterone in allaying these unpleasant symptoms in women with breast cancer are similar to the benefits of vaginal estrogen in women without breast cancer. AIM: The aim of this study was to evaluate the effects of using a daily vaginal testosterone cream on the reported sexual health quality of life in women with breast cancer taking AI therapy. METHODS: Thirteen postmenopausal women with breast cancer on AI therapy and experiencing symptoms of sexual dysfunction were recruited from an oncology practice. The women were prescribed a 300 µg testosterone vaginal cream daily for 4 weeks. During the first study visit, a vaginal swab was obtained to rule out the presence of Candida species or Gardnerella vaginalis in participants. Women with positive vaginal swabs were treated prior to starting the vaginal testosterone therapy. MAIN OUTCOME MEASURE: The Female Sexual Function Index (FSFI) survey, measuring female sexual health quality of life, was administered during the first study visit and at the final study visit, after completing testosterone therapy. RESULTS: Twelve patients completed 4 weeks of daily vaginal testosterone therapy. When compared with baseline FSFI scores, there was a statistically significant improvement for individual domain scores of desire (P = 0.000), arousal (P = 0.002), lubrication (P = 0.018), orgasm (P = 0.005), satisfaction (P = 0.001), and pain (P = 0.000). Total domain scores reflecting sexual health quality of life also improved when compared with baseline (P = 0.000). CONCLUSIONS: The use of a compounded testosterone vaginal cream applied daily for 4 weeks improves reported sexual health quality of life in women with breast cancer taking AIs. Dahir M and Travers-Gustafson D. Breast cancer, aromatase inhibitor therapy, and sexual functioning: A pilot study of the effects of vaginal testosterone therapy. Sex Med 2014;2:8-15.

The causes and prevalence of vestibulodynia: a vulvar pain disorder.

Vestibulodynia is a chronic type of vulvar pain that affects at least 16% of women in the United States. The condition is often misdiagnosed or not diagnosed at all due to a lack of knowledge among health care professionals. Delayed diagnosis puts a woman at risk for sexual dysfunction, decreased quality of life, and relationship conflict.

A sexual medicine health care model and nurse practitioner role.

The role of health care providers has not been clearly defined in sexual medicine and vulvar disease. The focus of this article is to describe the role of a nurse practitioner (NP) within a sexual medicine practice and explain how the NP functions with a multidisciplinary health care model that guides treatment of women with sexual dysfunction.

Treatment options for female sexual arousal disorder: part II.

Female sexual arousal disorder (FSAD) occurs when a woman experiences distress due to the inability to attain or maintain adequate vaginal lubrication. Many treatments are still under investigation, and at this time, there are no FDA-approved medications available for the treatment of FSAD. Treatment options include "off-label" medications, vaginal estrogen, compounded preparations, and over-the-counter products.

Testosterone for the treatment of hypoactive sexual desire disorder: part II.

There are no testosterone products approved for women by the Food and Drug Administration (FDA). Testosterone is often prescribed "off-label" to women for the treatment of hypoactive sexual desire disorder (HSDD).

The causes and prevalence of hypoactive sexual desire disorder: part I.

Hypoactive sexual desire disorder (HSDD) is the most common complaint among women experiencing sexual dysfunction. The cause of HSDD is often multifactorial, and there are no treatments approved by the Food and Drug Administration available to women at this time.

Female sexual dysfunction: barriers to treatment.

Treatment of female sexual dysfunction is a new and evolving area of nursing and medical care. The focus of this article is to create awareness of barriers women experience when seeking treatment for sexual dysfunction from health care professionals.

The physiology and causes of female sexual arousal disorder: part I.

Female sexual arousal disorder (FSAD) is a subtype of female sexual dysfunction. It occurs when a woman experiences distress due to the inability to attain or maintain adequate vaginal lubrication. Common causes of FSAD include a lack of vaginal estrogen, arterial insufficiency, tactile insensitivity, or relationship conflict.