Objective. The effect of hormone replacement therapy (HRT) on the sexual functioning and quality of life of breast cancer patients has not received significant attention.
Study design. One hundred postmenopausal women with early stage breast cancer who were experiencing vasomotor symptoms and/or vaginal dryness participated in a randomised trial of HRT.
Main outcome measures. Women completed questionnaires at three and six months to determine changes in their quality of life, vaginal dryness and sexual activity.
Results. At baseline, 52% (49/94) of patients were sexually active. Lack of a partner was the main reason for sexual inactivity (38% (17/45)). HRT had no significant effect on the proportion of women complaining of vaginal dryness or the severity of this symptom. HRT did not increase the proportion of women who were sexually active (53%(43/81)) but was associated with non-significant trends for improvements in pleasure and reduction of discomfort during intercourse. Non-significant trends towards improvements in physical functioning, sleep disturbance and fatigue were observed with HRT. Patient numbers were too small to determine whether the concomitant use of tamoxifen influenced any of these outcomes.
Conclusions. Lack of a significant improvement in quality of life with HRT may reflect the possibility that patient concern about HRT negated its symptomatic benefits. Failure of HRT to improve vaginal dryness may partly account for a lack of improvement in sexual functioning. There is a need for evaluation of interventions to improve sexual functioning in breast cancer patients but the use of hormonal therapy should be restricted to controlled trials.
