Debra L. Barton, RN, PhD, FAAN

Addressing the sexual health needs of women after treatment for breast cancer to improve their quality of life and maintain or restore intimacy.

Impact

A regimen of five or more years of anti-estrogen therapies, such as tamoxifen and aromatase inhibitors, is proven to be effective at reducing the recurrence of breast cancers driven by estrogen. However, many women taking anti-estrogen therapies experience unwanted side effects, such as sexual dysfunction, changes in libido, and vaginal discomfort. These effects can be so troublesome that some women may stop therapy before completing the recommended course. Unfortunately, this important aspect of survivorship is not often addressed during routine medical care. Dr. Barton is investigating ways to help women, and their partners regain intimacy, which is often put on hold during treatment. Management of these issues will help to improve patients’ quality of life during and after treatment.

Progress Thus Far

Dr. Barton and her team are developing and testing numerous tools as part of a toolkit that can be individualized to a woman’s needs. In the past year, the team completed a study evaluating the impact of using vaginal moisturizer with and without hypnosis to improve vulvo-vaginal symptoms, body image, and desire. They found both groups reported improvements in vaginal lubrication and in pain during intercourse. The group who used hypnosis reported improved body image and scored slightly better on the Female Sexual Function Index, a survey measuring the sexual functioning of women in six different domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Eighty three percent of the women who participated in this study reported being sexually active despite low vaginal lubrication and high levels of pain during intercourse, underscoring the need for further research in sexual health.

What’s next

The research team will complete their randomized pilot trial evaluating an interactive workbook to improve sexual communication and satisfaction between couples. They will conduct a clinical trial to evaluate how to combine the most effective interventions into one individualizable toolkit. An important outcome of this work is to provide oncologists with the tools needed to address the sexual health concerns of their patients, an area often overlooked or seen as too complex to address.