Hi @KymB
Happy to respond.
Apart from taking precautions about sex during chemo, I was not given any information about effects on my sexual health at the beginning of treatment. My oncologist is communicative and helpful, and as I didn't have any problems, I didn't ask further at that time.
I knew from the manufacturer's information that femara could cause vaginal dryness. It did, within 4 months to become apparent and within 6 months to cause pain and bleeding in vaginal intercourse. Medical advice was that it could be easily counteracted by oestrogen treatment but this was contraindicated given my diagnosis. Considerably later oestrogen cream was discussed but with a fair amount of 'it's up to you'. I was too wary to try. My choice.
Recently my breast surgeon has strongly suggested I use oestrogen cream as he is concerned about the possibility of prolapse. His careful and detailed analysis about my age, years on femara and risk has convinced me to give it a go. In a month, dryness is much improved and I am using the cream considerably less than the recommended amount.
My libido is still affected. There is no way of telling how much this is femara and how much is age but it's probably both. While my partner and I are reasonably inventive, we may not plunge back into the old routine as his sexual prowess and staying power isn't what it was 6 years ago either! It's annoying but we manage to
laugh about it as well. Say much the same about ageing too!
I have mixed feelings about what doctors should say or not say. A diagnosis of breast cancer, mastectomy and my oncologist's honest list of possible chemo side effects was quite enough - telling me at that point that I might effectively lose my sex life (that's how I would have seen it) might have propelled the imagined walk out of the consulting room into reality. At a first meeting, he didn't know me well enough for that! I have found that my medical team have answered questions honestly - that includes 'we don't know' or 'it's up to you'. I'd love them to have more definitive answers but often they just don't have that information. And it must be hard for an oncologist, early in treatment, to accurately assess what you can handle and what you can't. No easy answers. We do the best we can and look forward to better developments.
