Monash University trial to address the silent problem of breast cancer and sexual anxiety

Up to two thirds of women who have survived breast cancer report a loss of libido and an unsatisfactory sex life. This is particularly prevalent in women who take a type of drug known as an aromatase inhibitor, or AI, which blocks oestrogen production, leading to vaginal dryness, irritation, painful sex and urinary symptoms.

These symptoms can be very severe, resulting in avoidance of sexual activity and relationship distress. In 20% of cases, women stop taking their medication, increasing their risk of a relapse.

Monash University is starting the Sexual Wellbeing After Breast Cancer (SWAB) study, a world first trial to determine whether the use of testosterone cream can alleviate these symptoms and improve these women’s sex lives.

While vaginal oestrogen is offered to women who experience these symptoms after menopause (through natural loss of oestrogen), this is not an option in women who cannot risk any of the hormone triggering their cancer.

Susan DavisThe study run by Professor Susan Davis, Director of the Monash University Women’s Health Research Program, together with the National Breast Cancer Foundation, will test whether low dose of vaginal testosterone cream might be effective and safe for women taking an AI.

The randomised, double blind, placebo-controlled trial will take place over 26 weeks with three visits to the Alfred Centre, Melbourne, during that period. The trial is hoping to recruit 100 women who are presently taking an AI for breast cancer.

Participants will be given either the testosterone or a placebo cream. They will be asked to complete questionnaires about their symptoms, be examined and have their hormone levels measured in blood samples.

As well as potentially providing evidence for a new therapy for breast cancer survivors to assist in their anxiety and sexual health, Professor Davis hopes that the information about the study will trigger discussion about vaginal and urinary tract issues.

“This impacts a lot of women who suffer silently. We need to de-stigmatise the intimate issues and encourage affected women to seek help and feel more able to discuss their symptoms with their partner,” Professor Davis said.