Lidocaine for Dyspareunia in Breast Cancer Survivors
William J. Gradishar, MD reviewing Goetsch MF et al. J Clin Oncol 2015 Oct 20. Bezjak A and Ferguson SE. J Clin Oncol 2015 Oct 20.
Applying topical lidocaine prior to sexual intercourse significantly reduced penetration pain associated with dyspareunia.
One of the most common complaints from breast cancer survivors, if the subject is broached, relates to sexual dysfunction, of which there can be many manifestations, including lack of desire, body image, depression, and anxiety, as well as physical issues such as dyspareunia.
To explore whether aqueous lidocaine could prevent penetration pain associated with dyspareunia, investigators conducted a randomized, controlled, blinded study involving 46 breast cancer survivors with documented severe vulvovaginal atrophy, dyspareunia, increased sexual distress scores, or abnormal sexual dysfunction. Patients applied either saline or 4% aqueous lidocaine compresses 3 minutes prior to twice-weekly vaginal intercourse or tampon insertion. Thereafter, patients participated in a 2-month, open-label trial during which patients received lidocaine; the primary outcome was patient-reported penetration pain and secondary assessment of sexual function and distress.
Individuals receiving lidocaine in the blinded phase of the trial experienced significantly less pain during intercourse compared with those receiving saline. In the open-label phase of the trial, 90% of patients reported comfortable penetration. Scores of sexual function and distress also declined significantly with lidocaine use. Equally important, whereas almost 50% of patients abstained from intercourse before using lidocaine, 85% of them resumed sexual relations with intercourse after using lidocaine. None of the sexual partners of the participants experienced penile numbness.
Citation(s):
Goetsch MF et al. A practical solution for dyspareunia in breast cancer survivors: A randomized controlled trial. J Clin Oncol 2015 Oct 20; 33:3394.
Bezjak A and Ferguson SE.Sex: Taboos, assumptions, and evidence. J Clin Oncol 2015 Oct 20; 33:3370.
