March 2016 - Health Bulletin
Sensitive issue for women after breast cancer
Breast cancer is still the most common cancer in women in Australia. With the introduction of early diagnosis and hormone therapy the prognosis for women diagnosed with invasive breast cancer has improved substantially. Most women diagnosed with breast cancer in Australia have hormone sensitive disease and will be treated with medications that either block oestrogen action or oestrogen production. The medications that block oestrogen production (aromatase inhibitors, or AIs for short) are usually prescribed first, and often used for 5 or more years.
Side-effects of AIs, such as bone loss, can be managed with bone specific medications. However the effects on the vagina and urinary tract are not as easy to manage. Many women experience vaginal dryness, irritation, itching, infection, discomfort and painful sex. These symptoms are classed together as vulvovaginal atrophy (VVA) symptoms. Pain with intercourse and avoidance of sexual activity can lead to relationship disharmony. Our recent research has highlighted the deep distress many women experience in this setting.
Although low dose vaginal oestrogen, which is the standard treatment for these VVA symptoms, is sometimes used by women after breast cancer, it would be highly preferable to be able to offer women an effective non-estrogen alternative.
There is some evidence that a low dose of vaginal testosterone cream might be effective and safe for women taking an aromatase inhibitor.
We are conducting a clinical trial to evaluate the effectiveness and safety of intra-vaginal testosterone therapy in women taking an AI. We will determine the effects of vaginal testosterone cream, used 3 times a week, on vaginal health and urinary incontinence, as well as on sexual satisfaction and wellbeing.
Half of the women in the study will be randomly allocated to use the active medication and half will be the control group using placebo (inactive medication) for 26 weeks. The study will be conducted by our team at the Women’s Health Research Program, Monash University, the Alfred Centre, Melbourne and is supported by the National Breast Cancer Foundation.
We are now inviting women to participate in this study who are aged over 18 years, who are taking an AI and are experiencing symptoms of vaginal dryness, itch or pain with sexual activity.
If you are interested please email email@example.com or call 03 99030 827.
International Women’s Day
Professor Christina Mitchell, Monash University’s Dean of Medicine, celebrated International Women’s Day with female professors of the Faculty of Medicine, Nursing and Health Sciences. This was an important event for those present as 50% of medical students and a greater proportion of allied health scientists are women, women remain under represented as senior academics.
Professor Jayashri Kulkarni, Director of the Monash Alfred Psychiatry Research Centre, highlighted women’s mental health issues and Professor Susan Davis, of the Women’s Health Research Program talked about the importance of making quality health information available to the community.