No orgasm after breast cancer treatment: so frustrated

@jgallagher04921
How frustrating, I am sure after cancer and surgery you just want to have a normal life again.
Not familiar with all medical abbreviation, by DM, do you mean diabetes mellitus.

Were your ovaries removed to reduce estrogen as part of your treatment of breast cancer?

I can't either. I gave up trying. Its been a long time too. Im 59.

DM was for double mastectomy. Yes ovary removal was part of my treatment. Thank you for responding. I just wanted to scream after but chose to come on here and post my frustration instead.

This does sound very frustrating. A few thoughts...it might help to try and determine if the cause is physical, emotional, or both. Physical can be anything from hormone levels to nerve damage to post partum weakness, to more. I'd say cancer treatment in all its forms might be the culprit. If it was me, I'd review it first with my PCP, who as a rule tends to see "the whole person" more than my oncologist does. I also might address the issue privately. There are qualified sex therapists in systems like Kaiser who might help. And a quick look shows dozens of books on Amazon, so you are certainly not alone. If it is a pelvic floor issue there is excellent PT for that. You don't mention if you have a partner. Those scary conversations about intimate things can help, if you feel you'll get the support you need. With breast cancer one of my goals is to just continue feeling alive--and sexuality is part of that. I'm also trying to feel good when I can--walking, hot tub, massage, being outside. It can be a struggle, though, and you have my sympathy.

I’m so sorry you’re going through this. It is definitely an unhappy place.
I’m not sure if your doctor will write a prescription for a low dose estradiol tablet that is inserted vaginally while you’re taking an AI, like vagifem. Some women find it’s enough to help.
I think we women need to ask loudly and persistently for research that shows what is a safe level of circulating estrogen, absorbed vaginally, that will not cause BC recurrence. I have not seen a definitive study.
For me, the orgasm issue is whether there is estrogen absorbed on the clitoris. If we knew that a minimal, LeSuer pea size amount of estradiol cream placed directly on the clitoris would not increase the system estrogen level, then that might really help restore orgasms. I know my doctors will not prescribe estradiol cream to be used in this manner because there is no research showing it’s not harmful.

ACOG Supports the Use of Estrogen for Breast Cancer Survivors

Washington, DC—With 2 million breast cancer survivors now living in the United States, there is growing recognition among health care providers that quality of life issues for these women should be assessed and treated

Today, in a new Committee Opinion, "The Use of Vaginal Estrogen in Women with a History of Estrogen-Dependent Breast Cancer," the American College of Obstetricians and Gynecologists (ACOG) outlines the options and treatments for female-specific survivorship issues. One particular challenge for providers to understand and address are vaginal symptoms of menopause, whether naturally occurring or treatment-induced.

Many therapies that treat estrogen-dependent breast cancer cause vaginal atrophy and increase symptoms of vaginal dryness, bleeding, bacterial infections and painful sex. These symptoms may worsen over time and, as women live longer, may pose significant challenges. It is estimated that up to 20% of all patients terminate or consider terminating therapies due to the severe detrimental effect that vaginal atrophy poses on their quality of life.

According to the new Committee Opinion, for women with estrogen-dependent breast cancer or a history of estrogen-dependent breast cancer, non-hormonal options for vaginal atrophy should be the first choice. However, health practitioners may now consider topical estrogen therapy for patients with a history of estrogen-dependent breast cancer who are unresponsive to non-hormonal remedies. Although there is controversy related to the risk of topical estrogen therapy and breast cancer recurrence, the Committee Opinion notes that data show there is no increased risk of cancer recurrence with the use of topical vaginal estrogen.

Diana Nancy Contreras, MD, Chair of ACOG's Subcommittee on Gynecologic Oncology, stated, "These new recommendations are especially important and helpful because they provide the patient with the information needed to make an informed decision with the input of her health care provider."

Committee Opinion #659, "The Use of Vaginal Estrogen in Women with a History of Estrogen-Dependent Breast Cancer," is published in the March issue of Obstetrics & Gynecology.

For more information see Practice Bulletin #126, "Management of Gynecologic Issues in Women With Breast Cancer."

Other recommendations issued in the March Obstetrics & Gynecology:

I've been happily married for 21 years. This is most definitely all related to my diagnosis. I have talked to my oncologist. She feels it's side effect of AI and ovary removal. I started Addyi 3 weeks ago. Everything was great until I got the cancer. This is purely a physical issue w my body. I still get wet and horny but can't orgasim. And it takes so much effort to try I feel like passing out.

I'm so sorry!!!

I found that Tamoxifen helped with orgasms, as opposed to the other A.I. medications. I am ER, PR, positive so I can't use female hormones anymore. But, it is Testosterone that gives good orgasms in women, as well as men. I know about this. I also know that some Testosterone changes to Estrogen. I am trying to find out from doctors, who deal with hormone therapies, if there could be a safe, tiny level to take. Yes, it really sucks about that important part of our lives.