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    Research Grants Awarded

    OVER(Olive oil Vaginal Exercise and Replens)come - an intervention study to improve sexual function in women with breast cancer

    Study Section:
    Population Specific

    Scientific Abstract:
    The long-term impact of adjuvant chemotherapy and hormonal therapy on sexual function and quality of life of breast cancer survivors has been well documented. Longitudinal research suggests that between 30-50% of women with history of breast cancer experience dyspareunia, lubrication problems and symptoms of vaginismus. Poor vaginal lubrication results in dyspareunia, and there is often avoidance and anticipatory fear, along with involuntary pelvic floor muscle contraction. Whilst these problems are well documented, there have been very few studies addressing these issues. Most women are advised to use a vaginal lubricant during intercourse, but this alone is often inadequate. The use of Replens (a non-hormonal vaginal moisturizer) has been shown to alleviate vaginal dryness and improve dyspareunia in women with breast cancer. Similarly, symptoms of vaginismus can improve with relaxation exercises targeting the pelvic floor muscles (PFM). This pilot intervention study aims to prospectively evaluate the efficacy of an intervention using PFM relaxation exercises to prevent vaginismus, a vaginal moisturizer (Replens) to alleviate vaginal dryness, and olive oil as a lubricant during intercourse, to decrease sexual difficulties experienced following adjuvant treatment for breast cancer in women. It is anticipated that sexual functioning and quality of life will substantially improve post-intervention. Women with a diagnosis of breast cancer who have completed adjuvant chemotherapy, have had amenorrhea for the past 6 months or are currently on aromatase inhibitors, have symptoms of vaginal dryness and dyspareunia, and are in a sexually active relationship, are eligible for participation. The treating oncologists will introduce the study to eligible women, and interested women will be asked to self-refer to the study. This will be a 26-week intervention study, with interventions by a trained physiotherapist at weeks 0, 2, and 6 and follow-ups at weeks 14 and 26. Fifty eligible women will be recruited and data will be collected at baseline, and at each intervention and follow-up time point, using self-administered questionnaires with validated measures of sexual functioning, quality of life, and emotional outcomes. Readings of PFM functioning will also be recorded by the physiotherapist at each time point. If proven effective, this intervention has the potential to revolutionize the treatment of women with sexual problems following breast cancer treatment.

    Lay Abstract:
    The long-term effects of chemotherapy and hormonal therapy on sexual function and quality of life of women with breast cancer has been well documented. Research suggests that between 30-50% of women with breast cancer experience pain during sex, vaginal dryness and symptoms of painful tightening of the vagina. Vaginal dryness results in pain during sex, and there is often avoidance and anticipatory fear, along with unintentional pelvic floor muscle tightening. Whilst these problems are well documented, there have been very few studies addressing these issues. Most women are advised to use a vaginal lubricant during sex, but this alone is often not enough. The use of Replens (a non-hormonal vaginal moisturizer) has been shown to lessen vaginal dryness and improve pain during sex in women with breast cancer. Similarly, vaginal tightening can improve with relaxation exercises for the pelvic floor muscles (PFM). This pilot study aims to find out if PFM relaxation exercises to avoid vaginal tightening, a vaginal moisturizer (Replens) to ease vaginal dryness, and olive oil as a lubricant during sex, will lessen the sexual difficulties experienced by women with breast cancer. It is expected that sexual functioning and quality of life will greatly improve. Women with a diagnosis of breast cancer who have completed chemotherapy, have not menstruated for the past 6 months or are currently on aromatase inhibitors, have signs of vaginal dryness and pain during sex, and are in a sexually active relationship, are suitable to take part in this study. The treating oncologists will introduce the study to suitable women, and interested women will be asked to refer themselves to the study. This will be a 26-week study, with appointments with an experienced physiotherapist at weeks 0, 2, and 6 and follow-up appointments at weeks 14 and 26. Fifty suitable women will be included in the study and information will be collected at the beginning, and at each physiotherapy appointment time, using self-administered questionnaires with validated measures of sexual functioning, quality of life, and emotional outcomes. Readings of PFM functioning will also be recorded by the physiotherapist at each appointment. If found to be successful, this method has the potential to revolutionize the treatment of women with sexual problems following breast cancer treatment.