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Regular sexual activity to maintain vaginal health. Consumption of pure cranberry or lingonberry juice rather than cranberry drink to reduce the risk of recurrent urinary tract infections. For the treatment of local urogenital symptoms such as vaginal itching, irritation, and dyspareunia, regular application of vaginal moisturizers is an alternative to hormone replacement therapy. Vaginal estrogen therapy for menopausal women experiencing recurrent urinary tract infections.

Lifestyle: The sogc guidelines 60 encourage regular vaginal coital activity to increase blood circulation to the pelvic organs and avoidance of products that pose a risk of contact dermatitis of the vulva.

Vaginal Moisturizer: A non-hormonal moisturizing gel containing purified water, glycerine, mineral oil, polycarbophil, carbopol P, hydrogenated palm oil glyceride, and sorbic acid Replens: Wellspring Pharmaceutical Corporation, Bradenton, FL, U. Lubricants for Coital Comfort: Several lubricants that can be used to reduce immediate irritation during coital activity are available to women in Canada, but no evidence currently exists that these products have any long-term therapeutic effect Lubricants for Vaginal Dryness: Orally administered or locally applied vitamin E in daily doses of — IU has been found to increase vaginal lubrication and to relieve the dryness and irritation that accompany atrophic and other forms of vaginitis.

Hormonal Therapies for Urogenital Atrophy, Vaginitis, and Dyspareunia: In general, non-hormonal treatments are the first-line recommendation in breast cancer patients , When did you start noticing a change in your interest in sex? Do you have problems with arousal or getting sufficiently lubricated? Are you able to reach orgasm? How often do you experience discomfort or pain during sex? Assessment of chronic dyspareunia SOGC guidelines Is vaginal entry possible at all that is, with finger, penis, speculum, tampon?

Do you get sexually aroused at the beginning of and during intercourse? Exactly when does the pain arise? During entry of penile head? With partial penile entry? With deep penetration? With movement of the penis? During or following ejaculation? Following subsequent urination? Is there less or greater degree of pain at times, and any idea why? Do you have any inhibitions or thoughts that interfere with your level of desire?

Any spontaneous sexual thoughts or fantasies? Are you aroused by erotic descriptions in books or sex scenes in movies? How often do you masturbate? Do you find your partner attractive? Do you find other men or women attractive? Sample questions for women with decreased arousal: When did you notice a change in your level of arousal? Does masturbation offer you real pleasure or just momentary thrill? Are there any sexual activities that you and your partner s engage in for pleasure?

Do you find your partner s responsive when you talk about sex? Sample questions for women with difficulty achieving orgasm Have you ever had an orgasm or heard of female genital structures, such as the clitoris? Do you participate in sexual activities that involve stimulation of the clitoris? Do you really get distracted during an orgasm? Version 2. Aromatase cytochrome P, the enzyme responsible for estrogen biosynthesis. Endocr Rev. A link between breast cancer and local estrogen biosynthesis suggested by quantification of breast adipose tissue aromatase cytochrome P transcripts using competitive polymerase chain reaction after reverse transcription.

J Clin Endocrinol Metab. In vivo inhibition of aromatization by exemestane, a novel irreversible aromatase inhibitor, in postmenopausal breast cancer patients. Clin Cancer Res. Influence of anastrozole Arimidex , a selective, non-steroidal aromatase inhibitor, on in vivo aromatization and plasma oestrogen levels in postmenopausal women with breast cancer. Br J Cancer. In vivo measurement of aromatase inhibition by letrozole cgs in postmenopausal patients with breast cancer.

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Influence of letrozole and anastrozole on total body aromatization and plasma estrogen levels in postmenopausal breast cancer patients evaluated in a randomized, cross-over study. J Clin Oncol. Letrozole CGS A phase i study of a new potent oral aromatase inhibitor of breast cancer. Double-blind, randomised, multicentre endocrine trial comparing two letrozole doses, in postmenopausal breast cancer patients. Eur J Cancer. Endometrial cancer in tamoxifen-treated breast cancer patients: findings from the National Surgical Adjuvant Breast and Bowel Project nsabp B J Natl Cancer Inst.

Adjuvant tamoxifen in early breast cancer: occurrence of new primary cancers. Adjuvant tamoxifen therapy for early stage breast cancer and second primary malignancies. Stockholm Breast Cancer Study Group. High-grade endometrial carcinoma in tamoxifen-treated breast cancer patients. Risk of endometrial cancer after tamoxifen treatment of breast cancer. Obstet Gynecol. Stearns V, Gelmann EP. Does tamoxifen cause cancer in humans? Effects of adjuvant tamoxifen on the endometrium in postmenopausal women with breast cancer: a prospective long-term study using transvaginal ultrasound.

Third generation aromatase inhibitors may prevent endometrial growth and reverse tamoxifen-induced uterine changes in postmenopausal breast cancer patients. Ann Oncol.

Double Menopause: What to Do When Both You and Your Mate Go Through Hormonal Changes Together

American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor positive breast cancer: status report The role of aromatase inhibitors in the adjuvant treatment of breast carcinoma: the M. Anderson Cancer Center evidence-based approach.

Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the atac randomised trial. Duffy S. Hum Reprod. Anastrozole versus tamoxifen treatment in postmenopausal women with endocrine-responsive breast cancer and tamoxifen-induced endometrial pathology. Cella D, Fallowfield L. Five-year quality of life qol follow-up of adjuvant endocrine therapy for postmenopausal women in the Arimidex A , Tamoxifen T , Alone or in Combination atac trial.

Does switching to letrozole improve hot flushes, mood and quality of life in tamoxifen intolerant patients? Breast Cancer Res Treat. A comparison of letrozole and tamoxifen in postmenopausal women with early breast cancer. N Engl J Med.

What you need to know about HRT

A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. Assessment of quality of life in ma. A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer.

A planned comparison of menopausal symptoms during year 1 in patients receiving either exemestane or tamoxifen in a double-blind hormonal adjuvant study. Potential future options in the pharmacotherapy of female sexual dysfunction. World J Urol. Sexual dysfunction in the peri- and postmenopause. Status of incidence, pharmacological treatment and possible risks. A secondary publication. Dan Med Bull. Potter JE. A year-old woman with sexual difficulties. The protective effects of estrogen on the cardiovascular system. Endocrine and intracrine sources of androgen: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone.

The proactive sexual health history. Am Fam Physician. Basson R. Sexual desire and arousal disorders in women. Sexual concerns—menopause and sexual function. J Obstet Gynaecol Can. Wylie KR. Sexuality and the menopause. J Br Menopause Soc. Endocrine aspects of female sexual dysfunction.

J Sex Med. Elliott S. Sexual dysfunction and infertility in men with spinal cord disorders. In: Lin Vernon. Spinal Cord Medicine: Principles and Practice. New York: Demos Medical Publishing; Clinical evaluation and management strategy for sexual dysfunction in men and women. North American Menopause Society.

The role of testosterone therapy in postmenopausal women: position statement of The North American Menopause Society. Guay AT. Screening for androgen deficiency in women: methodological and interpretive issues. Fertil Steril. Androgen therapy in women: an Endocrine Society Practice Guideline. Adipose aromatase gene expression is greater in older women and is unaffected by post-menopausal estrogen therapy. Basson R, Weijmar Schultz W. Sexual sequelae of general medical disorders. Masters WVJ. Human Sexual Response.

Boston, MA: Little, Brown; Kaplan HS. The New Sex Therapy. The female sexual response: A different model. J Sex Marital Ther. Sand M, Fisher WA. Billups KL. The role of mechanical devices in treating female sexual dysfunction and enhancing the female sexual response. A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Arch Sex Behav.

Society of Obstetricians and Gynaecologists of Canada. The detection and management of vaginal atrophy. Int J Gynaecol Obstet.

What Is Seed Cycling? Effects on Hormones and Menopause

Adverse effects of drug therapies on male and female sexual function. Therapeutic options for the management of hot flashes in breast cancer survivors: an evidence-based review. Clin Ther. Graziottin A. London: Taylor and Francis; Quality of life following breast-conserving therapy or mastectomy: result of a 5 year prospective study. Breast J. Becoming sexually active again. Goldstein I.

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Current management strategies of the postmenopausal patient and sexual health problems. Sarrel PM. Sexuality and menopause. Effects of hormone replacement therapy on sexual psychophysiology and behavior in postmenopause. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. Holmberg L, Anderson H. Menopausal hormone therapy after breast cancer: the Stockholm Randomized Trial.

Schwenkhagen A. Hormonal changes in menopause and implications on sexual health. Guay A. Int J Impot Res. Breast cancer incidence in postmenopausal women using testosterone in addition to usual hormone therapy. Androgens and the breast. Somboonporn W, Davis SR. Testosterone effects on the breast: implications for testosterone therapy for women.

Randomized controlled trial to evaluate transdermal testosterone in female cancer survivors with decreased libido: North Central Cancer Treatment Group Protocol NO02C3. Female sexual desire—beyond testosterone. Safety and efficacy of sildenafil citrate for the treatment of female sexual arousal disorder: a double-blind, placebo controlled study. J Urol. Modeling and simulation of sexual activity daily diary data of patients with female sexual arousal disorder treated with sildenafil citrate Viagra Pharm Res. Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female sexual arousal disorder.

Basson R, Brotto LA. Sexual psychophysiology and effects of sildenafil citrate in oestroegenized women with acquired genital arousal disorder and impaired orgasm: a randomized controlled trial. Taylor MJ. Strategies for managing antidepressant-induced sexual dysfunction: a review. Curr Psychiatry Rep. Sexual activity with and without the use of sildenafil: risk of cardiovascular events in patients with heart disease. Ital Heart J. Topical alprostadil pge1 for the treatment of female sexual arousal disorder: inclinic evaluation of safety and efficacy.

J Psychosom Obstet Gynaecol. Topical alprostadil treatment of female sexual arousal disorder. Ann Pharmacother. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. J Clin Psychopharmacol.

A double-blind comparison between bupropion XL and venlafaxine XR. A double-blind placebo-controlled study of Arginmax, a nutritional supplement for enhancement of female sexual function. Fourcroy JL. Female sexual dysfunction: potential for pharmacotherapy. Segraves RT. Emerging therapies for female sexual dysfunction. Expert Opin Emerg Drugs. Diagnosis and treatment of atrophic vaginitis. Management of post-menopausal vaginal atrophy and atrophic vaginitis. Prevalence of bacterial vaginitis and vaginosis: association with clinical and laboratory features, and treatment [Spanish] Ginecol Obstet Mex.

The relationship of bacterial vaginosis, Candida and Trichomonas infection to symptomatic vaginitis in postmenopausal women attending a vaginitis clinic. Chronic vaginal candidiasis. Management in the postmenopausal patient. Drugs Aging. Stress and immune responses after surgical treatment for regional breast cancer. Does subjective burden of early breast cancer and its treatment affect immune measures during adjuvant therapy? Ventolini G, Baggish MS. Postmenopausal recurrent vaginal candidiasis: effect of hysterectomy on response to treatment, type of colonization and recurrence rates post-treatment.

Evaluation of vaginal complaints. Randomised trial of cranberry—lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women.

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Society of Obstetricians and Gynaecologists of Canada sogc Use of hormonal replacement therapy after treatment of breast cancer. Use of hormonal replacement therapy after treatment of breast cancer. Baber R.

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Hormone therapy and breast, ovarian and endometrial cancer. Menopausal Med. Canadian consensus conference on menopause, update. Oestradiol-releasing vaginal ring for treatment of postmenopausal urogenital atrophy. Read the Review. Mexico City is known for its many cultural attractions and a flourishing cultural scene. Your ancestors slept in a way that modern sleepers would find bizarre. Website URL:. I want to order one for every client I have. Finally, a book written for women about men by the world's leading expert on men's health.

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