under the covers: sex, intimacy and breast cancer...under the covers: sex, intimacy and breast...
TRANSCRIPT
Under the covers: Sex, intimacy and breast cancer
Anne Katz PhD RN FAAN
LBBC April 25, 2018
Interventions
• Vulvo-vaginal dryness
– Non-pharmaceutical (Krychman 2012)
– Moisturizers
– Lubricants
– Pharmaceutical
• Local estrogen (estriol) (Bucholz 2015)
• Local testosterone (Dahir 2014)
• Lidocaine (Goetsch 2015)
Moisturizers
• Vulvar dryness, itching, irritation
Lubricants
• Sex play and penetration
What about?
Help with arousal or loss of sensation
Flibanserin (Addyi)
Vulvo-vaginal rejuvenation (lasers)
• Not FDA approved
• Small studies
• No long term data
• Optimal regimen not established
• No good evidence for use in women with cancer
• EXPENSIVE
Psychosocial interventions
• Limited evidence of psychosocial interventions
• Couple based sex therapy (Carroll 2016)
– Sensate focus
– Coping and attachment
– Emotion focused therapy
• Education about reactive libido
Mindfulness-based meditation
COMMUNICATION
Partner
Health care providers
Pharmacist
Psychosocial clinicians