Management of sexual dysfunction in postmenopausal breast cancer patients taking adjuvant aromatase inhibitor therapy

Current Oncology

Volumn 14, Issue S1, 2007, Pages S20-S40

  Derzko, C ^a   Elliott, S ^b   Lam, W ^c  

^a ST MICHAEL'S HOSPITAL   (Canada)

^b UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^c Burnaby Hospital   (Canada)

Author keywords

Aromatase inhibitor therapy; Breast cancer; Gynecologic side effects; Hormone therapy; Sexual dysfunction; Side effect management; Side effect treatment

Indexed keywords

EID: 47749140838     PISSN: None     EISSN: 17187729     Source Type: Journal    
DOI: 10.3747/co.2007.151     Document Type: Review

References (115)

1. Ferlay J, Bray F, Pisani P, Parkin DM. GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide. International Agency for Research on Cancer (IARC) CancerBase No. 5. Version 2.0. Lyon, France: IARC Press; 2004.
2. Simpson ER, Mahendroo MS, Means GD, et al. Aromatase cytochrome P450, the enzyme responsible for estrogen biosynthesis. Endocr Rev 1994;15:342-55.
3. Bulun SE, Price TM, Aitken J, Mahendroo MS, Simpson ER. A link between breast cancer and local estrogen biosynthesis suggested by quantification of breast adipose tissue aromatase cytochrome P450 transcripts using competitive polymerase chain reaction after reverse transcription. J Clin Endocrinol Metab 1993;77:1622-8.
4. Geisler J, King N, Anker G, et al. In vivo inhibition of aromatization by exemestane, a novel irreversible aromatase inhibitor, in postmenopausal breast cancer patients. Clin Cancer Res 1998;4:2089-93.
5. Geisler J, King N, Dowsett M, et al. Influence of anastrozole (Arimidex), a selective, non-steroidal aromatase inhibitor, on in vivo aromatization and plasma oestrogen levels in postmenopausal women with breast cancer. Br J Cancer 1996;74: 1286-91.
6. Dowsett M, Jones A, Johnston SR, Jacobs S, Trunet P, Smith IE. In vivo measurement of aromatase inhibition by letrozole (CGS 20267) in postmenopausal patients with breast cancer. Clin Cancer Res 1995;1:1511-15.
7. Geisler J, Haynes B, Anker G, Dowsett M, Lonning PE. Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study. J Clin Oncol 2002;20:751-7.
8. Lipton A, Demers LM, Harvey HA, et al. Letrozole (CGS 20267). A phase I study of a new potent oral aromatase inhibitor of breast cancer. Cancer 1995;75:2132-8.
9. Bajetta E, Zilembo N, Dowsett M, et al. Double-blind, randomised, multicentre endocrine trial comparing two letrozole doses, in postmenopausal breast cancer patients. Eur J Cancer 1999;35:208-13.
10. Fisher B, Costantino JP, Redmond CK, Fisher ER, Wickerham DL, Cronin WM. Endometrial cancer in tamoxifen-treated breast cancer patients: Findings from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14. J Natl Cancer Inst 1994;86:527-37.
11. Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst 1998;90:1371-88.
12. Fornander T, Rutqvist LE, Cedermark B, et al. Adjuvant tamoxifen in early breast cancer: Occurrence of new primary cancers. Lancet 1989;1:117-20.
13. Rutqvist LE, Johansson H, Signomklao T, Johansson U, Fornander T, Wilking N. Adjuvant tamoxifen therapy for early stage breast cancer and second primary malignancies. Stockholm Breast Cancer Study Group. J Natl Cancer Inst 1995; 87:645-51.
14. Magriples U, Naftolin F, Schwartz PE, Carcangiu ML. Highgrade endometrial carcinoma in tamoxifen-treated breast cancer patients. J Clin Oncol 1993;11:485-90.
15. Curtis RE, Boice JD Jr, Shriner DA, Hankey BF, Fraumeni JF Jr. Second cancers after adjuvant tamoxifen therapy for breast cancer. J Natl Cancer Inst 1996;88:832-4.
16. van Leeuwen FE, Benraadt J, Coebergh JW, et al. Risk of endometrial cancer after tamoxifen treatment of breast cancer. Lancet 1994;343:448-52.
17. Seoud MA, Johnson J, Weed JC Jr. Gynecologic tumors in tamoxifen-treated women with breast cancer. Obstet Gynecol 1993;82:165-9.
18. Stearns V, Gelmann EP. Does tamoxifen cause cancer in humans? J Clin Oncol 1998;16:779-92.
19. Gerber B, Krause A, Muller H, et al. Effects of adjuvant tamoxifen on the endometrium in postmenopausal women with breast cancer: A prospective long-term study using transvaginal ultrasound. J Clin Oncol 2000;18:3464-70.
20. Morales L, Timmerman D, Neven P, et al. Third generation aromatase inhibitors may prevent endometrial growth and reverse tamoxifen-induced uterine changes in postmenopausal breast cancer patients. Ann Oncol 2005;16:70-4.
21. Winer EP, Hudis C, Burstein HJ, et al. American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor positive breast cancer: Status report 2004. J Clin Oncol 2005;23:619-29.
22. Morandi P, Rouzier R, Altundag K, Buzdar AU, Theriault RL, Hortobagyi G. The role of aromatase inhibitors in the adjuvant treatment of breast carcinoma: The M.D. Anderson Cancer Center evidence-based approach. Cancer 2004;101: 1482-9.
23. Baum M, Buzdar AU, Cuzick J, et al. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: First results of the ATAC randomised trial. Lancet 2002; 359:2131-9.
24. Howell A, Cuziak J, Baum M, et al. Results of the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years’ adjuvant treatment for breast cancer. Lancet 2005;365:60-2.
25. Duffy S. Gynaecological adverse events and hysterectomies in the ATAC (“Arimidex”, Tamoxifen, Alone or in Combination) trial [abstract 268]. Eur J Cancer 2005;3(suppl 3):75.
26. Duffy S, Jackson TL, Lansdown M, et al. The ATAC (“Arimidex,” Tamoxifen, Alone or in Combination) adjuvant breast cancer trial: First results of the endometrial sub-protocol following 2 years of treatment. Hum Reprod 2006;21: 545-53.
27. Gerber B, Krause A, Reimer T, et al. Anastrozole versus tamoxifen treatment in postmenopausal women with endocrine-responsive breast cancer and tamoxifen-induced endometrial pathology. Clin Cancer Res 2006;12:1245-50.
28. Fallowfield L, Cella D, Cuzick J, Francis S, Locker G, Howell A. Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) Adjuvant Breast Cancer Trial. J Clin Oncol 2004;22:4261-71.
29. Cella D, Fallowfield L. Five-year quality of life (QOL) followup of adjuvant endocrine therapy for postmenopausal women in the Arimidex (A), Tamoxifen (T), Alone or in Combination (ATAC) trial. J Clin Oncol 2005;23(suppl 16):577.
30. Thomas RJ, Marshall CJ, Williams M, Walker LG. Does switching to letrozole improve hot flushes, mood and quality of life in tamoxifen intolerant patients? Breast Cancer Res Treat 2005;94(suppl 1):2067.
31. Thurlimann B, Keshaviah A, Coates AS, et al. A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med 2005;353:2747-57.
32. Goss PE, Ingle JN, Martino S, et al. A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 2003; 349:1793-802.
33. Whelan TJ, Goss PE, Ingle JN, et al. Assessment of quality of life in MA.17: A randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women. J Clin Oncol 2005;23:6931-40.
34. Coombes RC, Hall E, Gibson LJ, et al. A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med 2004;350:1081-92.
35. Jones SE, Vukelja S, Cantrell J, et al. A planned comparison of menopausal symptoms during year 1 in patients receiving either exemestane or tamoxifen in a double-blind hormonal adjuvant study. Breast Cancer Res Treat 2003;82(suppl 31):141.
36. Uckert S, Mayer ME, Jonas U, Stief CG. Potential future options in the pharmacotherapy of female sexual dysfunction. World J Urol 2006;24:630-8.
37. Gregersen N, Jensen PT, Giraldi AE. Sexual dysfunction in the peri- and postmenopause. Status of incidence, pharmacological treatment and possible risks. A secondary publication. Dan Med Bull 2006;53:349-53.
38. Potter JE. A 60-year-old woman with sexual difficulties JAMA 2007;297:620-33.
39. Mendelsohn ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Engl J Med 1999;340: 1801-11.
40. Labrie F, Luu-The V, Labrie C, et al. Endocrine and intracrine sources of androgen: Inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Endocr Rev 2003;24:152-82.
41. Nusbaum MR, Hamilton CD. The proactive sexual health history. Am Fam Physician 2002;66:1705-12.
42. Basson R. Sexual desire and arousal disorders in women. N Engl J Med 2006;354:1497-506.
43. Basson R. Sexual concerns—menopause and sexual function. J Obstet Gynaecol Can 2006;28:S43-52. [Available online at: Www.sogc.org/guidelines/public/171E-CONSFebruary2006. pdf; cited January 2007]
44. Wylie KR. Sexuality and the menopause. J Br Menopause Soc 2006;12:149-52.
45. Davis SR, Guay AT, Shifren JL, Mazer NA. Endocrine aspects of female sexual dysfunction. J Sex Med 2004;1:82-6.
46. Elliott S. Sexual dysfunction and infertility in men with spinal cord disorders. In: Vernon Lin, ed. Spinal Cord Medicine: Principles and Practice. New York: Demos Medical Publishing; 2003.
47. Hatzichristou D, Rosen RC, Broderick G, et al. Clinical evaluation and management strategy for sexual dysfunction in men and women. J Sex Med 2004;1:49-57.
48. North American Menopause Society. The role of testosterone therapy in postmenopausal women: Position statement of The North American Menopause Society. Menopause 2005;12: 496-511.
49. Guay AT. Screening for androgen deficiency in women: Methodological and interpretive issues. Fertil Steril 2002;77(suppl 4):S83-8.
50. Wierman M, Basson R, Davis S, et al. Androgen therapy in women: An Endocrine Society Practice Guideline. J Clin Endocrinol Metab 2006;91:3697-710.
51. Misso ML, Jang C, Adams J, et al. Adipose aromatase gene expression is greater in older women and is unaffected by postmenopausal estrogen therapy. Menopause 2005;12:210-15.
52. Basson R, Weijmar Schultz W. Sexual sequelae of general medical disorders. Lancet 2007;369:409-24.
53. Masters WVJ. Human Sexual Response. Boston, MA: Little, Brown; 1966.
54. Kaplan HS. The New Sex Therapy. New York, NY: Brunner Mazel; 1974.
55. Basson R. The female sexual response: A different model. J Sex Marital Ther 2000;26:51-65.
56. Sand M, Fisher WA. Women’s endorsement of models of female sexual response: The Nurse’s Sexuality Study. J Sex Med 2007;4:708-19.
57. Billups KL. The role of mechanical devices in treating female sexual dysfunction and enhancing the female sexual response. World J Urol 2002;20:137-41.
58. Brotto LA, Heiman JR, Goff B, et al. A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Arch Sex Behav 2007;[Epub ahead of print].
59. Weijmar Schultz W, Basson R, Binik Y, Eschenbach D, Wesselmann U, Van Lankveld J. Women’s sexual pain and its management. J Sex Med 2005;2:301-16.
60. Society of Obstetricians and Gynaecologists of Canada. SOGC clinical practice guidelines. The detection and management of vaginal atrophy. Int J Gynaecol Obstet 2005;88:222-8.
61. Stadler T, Bader M, Uckert S, Staehler M, Becker A, Stief CG. Adverse effects of drug therapies on male and female sexual function. World J Urol 2006;24:623-9.
62. Bordeleau L, Pritchard K, Goodwin P, Loprinzi C. Therapeutic options for the management of hot flashes in breast cancer survivors: An evidence-based review. Clin Ther 2007;29: 230-41.
63. Graziottin A. Breast cancer and its effect on women’s body image and sexual function. In: Goldstein I, Meston C, Davis S, Traish A, eds. Women’s Sexual Function and Dysfunction. London: Taylor and Francis; 2006: 276-81.
64. Engel J, Kerr J, Schlesinger-Raab A, Sauer H, Holzel D. Quality of life following breast-conserving therapy or mastectomy: Result of a 5 year prospective study. Breast J 2004;10:223-31.
65. Derzko CM, Bullard DG, Rosenbaum EH, Dollinger M, Rosenbaum IR. Becoming sexually active again. In: Dollinger M, Rosenbaum EH, Tempero G, Mulvihill S, eds. Everyone’s Guide to Cancer Therapy. 4th ed. Kansas City, MO: Andrews McMeel Publishing; 2006: 223-35.
66. Goldstein I. Current management strategies of the postmenopausal patient and sexual health problems. J Sex Med 2007; 4(suppl 3):235-53.
67. Sarrel PM. Sexuality and menopause. Obstet Gynecol 1990; 75(suppl 4):26S-30S.
68. Sarrel PM. Effects of hormone replacement therapy on sexual psychophysiology and behavior in postmenopause. J Womens Health Gend Based Med 2000;9(suppl 1):S25-32.
69. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. Principal results from the Women’s Health Initiative randomized control trial. JAMA 2002;288: 321-33.
70. Holmberg L, Anderson H. HABITS (Hormonal replacement therapy After Breast Cancer—Is It Safe?), a randomized comparison: Trial stopped. Lancet 2004;363:453-5.
71. von Schoultz E, Rutqvist LE. Menopausal hormone therapy after breast cancer: The Stockholm Randomized Trial. J Natl Cancer Inst 2005;97:533-35.
72. Schwenkhagen A. Hormonal changes in menopause and implications on sexual health. J Sex Med 2007;4(suppl 3):220-6.
73. Guay A. Commentary on androgen deficiency in women and the FDA advisory board’s recent decision to request more safety data. Int J Impot Res 2005;17:375-6.
74. Dimitrakakis C, Jones R, Liu A, Bondy CA. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Menopause 2004;11:531-5.
75. Hofling M, Hirschberg AL, Skoog L, Tani E, Hagerstrom T, von Schoultz B. Testosterone inhibits estrogen/progestogeninduced breast cell proliferation in postmenopausal women. Menopause 2007;14:183-90.
76. von Schoultz B. Androgens and the breast. Maturitas 2007; 57:47-9.
77. Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: Contribution of the DHEA Age Study to a sociobiomedical issue. Proc Natl Acad Sci U S A 2000;97:4279-84.
78. Somboonporn W, Davis SR. Testosterone effects on the breast: Implications for testosterone therapy for women. Endocr Rev 2004;25:374-88.
79. Barton D, Wender DB, Slaon JA, et al. Randomized controlled trial to evaluate transdermal testosterone in female cancer survivors with decreased libido: North Central Cancer Treatment Group Protocol NO02C3. J Natl Cancer Inst 2007;99:672-9.
80. Ganz PA, Greendale GA. Female sexual desire—beyond testosterone. J Natl Cancer Inst 2007;99:659-61.
81. Berman JR, Berman LA, Toler SM, Gill J, Haughie S, on behalf of the Sildenafil Study Group. Safety and efficacy of sildenafil citrate for the treatment of female sexual arousal disorder: A double-blind, placebo controlled study. J Urol 2003; 170:2333-8.
82. Claret L, Cox EH, McFadyen L, et al. Modeling and simulation of sexual activity daily diary data of patients with female sexual arousal disorder treated with sildenafil citrate (Viagra). Pharm Res 2006;23:1756-64.
83. Basson R, McInnes R, Smith MD, Hodgson G, Koppiker N. Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female sexual arousal disorder. J Womens Health Gend Based Med 2002;11:367-77.
84. Basson R, Brotto LA. Sexual psychophysiology and effects of sildenafil citrate in oestroegenized women with acquired genital arousal disorder and impaired orgasm: A randomized controlled trial. BJOG 2003;110:1014-24.
85. Taylor MJ. Strategies for managing antidepressant-induced sexual dysfunction: A review. Curr Psychiatry Rep 2006; 8:431-6.
86. Alboni P, Bettiol K, Fuca G, Pacchioni F, Scarfo S. Sexual activity with and without the use of sildenafil: Risk of cardiovascular events in patients with heart disease. Ital Heart J 2004; 5:343-9.
87. Heiman JR, Gittelman M, Costabile R, et al. Topical alprostadil (PGE1) for the treatment of female sexual arousal disorder: Inclinic evaluation of safety and efficacy. J Psychosom Obstet Gynaecol 2006;27:31-41.
88. Kielbasa LA, Daniel KL. Topical alprostadil treatment of female sexual arousal disorder. Ann Pharmacother 2006;40: 1369-76.
89. Clayton AH, Warnock JK, Kornstein SG, Pinkerton R, Sheldon-Keler A, McGarvey EL. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry 2004; 65:62-7.
90. Segraves RT, Clayton A, Croft H, Wolf A, Warnock J. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. J Clin Psychopharmacol 2004;24:339-42.
91. Thase ME, Clayton AH, Haight BR, Thompson AH, Modell JG, Johnston JA. A double-blind comparison between bupropion XL and venlafaxine XR. J Clin Psychopharmacol 2006;26:482-8.
92. Ito TY, Trant AS, Polan ML. A double-blind placebo-controlled study of Arginmax, a nutritional supplement for enhancement of female sexual function. J Sex Marital Ther 2001;27:541-9.
93. Fourcroy JL. Female sexual dysfunction: Potential for pharmacotherapy. Drugs 2003;63:1445-57.
94. Segraves RT. Emerging therapies for female sexual dysfunction. Expert Opin Emerg Drugs 2003;8:515-22.
95. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician 2000;61:3090-6.
96. Castelo-Branco C, Cancelo MJ, Villero J, Nohales F, Julia MD. Management of post-menopausal vaginal atrophy and atrophic vaginitis. Maturitas 2005;52(suppl 1):S46-52.
97. Rivera LR, Trenado MQ, Valdez AC, Gonzalez CJ. Prevalence of bacterial vaginitis and vaginosis: Association with clinical and laboratory features, and treatment [Spanish]. Ginecol Obstet Mex 1996;64:26-35.
98. Spinillo A, Bernuzzi AM, Cevini C, Gulminetti R, Luzi S, De Santolo A. The relationship of bacterial vaginosis, Candida and Trichomonas infection to symptomatic vaginitis in postmenopausal women attending a vaginitis clinic. Maturitas 1997;27:253-60.
99. Nwokolo NC, Boag FC. Chronic vaginal candidiasis. Management in the postmenopausal patient. Drugs Aging 2000;16: 335-9.
100. Andersen BL, Farrar WB, Golden-Kreutz D, et al. Stress and immune responses after surgical treatment for regional breast cancer. J Natl Cancer Inst 1998;90:30-6.
101. Sabbioni ME, Bernhard J, Siegrist HP, et al. Does subjective burden of early breast cancer and its treatment affect immune measures during adjuvant therapy? Breast Cancer Res Treat 2004;87:75-86.
102. Ventolini G, Baggish MS. Post-menopausal recurrent vaginal candidiasis: Effect of hysterectomy on response to treatment, type of colonization and recurrence rates post-treatment. Maturitas 2005;51:294-8.
103. Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA 2004;291:1368-79.
104. American College of Obstetricians and Gynecologists (ACOG), Committee on Patient Education. Disorders of the Vulva [patient education pamphlet]. Washington, DC: ACOG; 2007. [Available online at: Www.acog.org/publications/patient_education/bp088.cfm; cited July 2007]
105. Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ 2001;322:1571.
106. Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in post-menopausal women. Maturitas 1996;23:259-63.
107. Society of Obstetricians and Gynaecologists of Canada (SOGC). Use of hormonal replacement therapy after treatment of breast cancer. Int J Gynaecol Obstet 2005;88:216-21.
108. Lea R, Bannister E, Case A, et al. Use of hormonal replacement therapy after treatment of breast cancer. J Obstet Gynaecol Can 2004;26:49-60.
109. Baber R. Hormone therapy and breast, ovarian and endometrial cancer. Menopausal Med 2007;14:S8-12.
110. Belisle S, Blake J, Basson R, et al. Canadian consensus conference on menopause, 2006 update. J Obstet Gynaecol Can 2006;28(suppl 1):S7-94. [Available online at: Www.sogc.org/guidelines/public/171E-CONS-February2006.pdf; cited July2007]
111. Smith P, Heimer G, Lindskog M, Ulmsten U. Oestradiol-releasing vaginal ring for treatment of postmenopausal urogenital atrophy. Maturitas 1993;16:145-54.
112. Kendall A, Dowsett M, Folkerd E, Smith I. Caution: Vaginal estradiol appears to be contraindicated in postmenopausal women on adjuvant aromatase inhibitors. Ann Oncol 2006; 17:584-7.
113. Powles TJ, Hickish T, Casey S, O’Brien M. Hormone replacement after breast cancer. Lancet 1993;342:60-1.
114. Powles TJ, Ashley S. Tamoxifen and oestrogen replacement. Lancet 1990;336:48.
115. Horn Y, Walach N, Pavlotsky A, Barak F, Benz C. Randomized study comparing chemotherapy with and without estrogen priming in advanced breast cancer. Int J Oncol 1994; 4:499-501.