The impact of aromatase inhibitors on sexual functioning: current knowledge and future research directions

There is substantial evidence supporting the adjuvant usage of aromatase inhibitors (AIs) in the treatment of postmenopausal women with early breast cancer. However, the exacerbation of postmenopausal gynaecological symptoms such as vaginal dryness and dyspareunia has been reported in several studies investigating the quality of life (QOL) of women taking AIs. If not managed appropriately, these symptoms may result in sexual dysfunction, which can in turn affect a woman's QOL. There is a paucity of comprehensive research into the prevalence, nature and management of sexual dysfunction in women who receive AIs. We have performed a comprehensive literature review of the area and have also offered future research directions, including a description of an intervention study currently underway in Australia, which aims to improve sexual dysfunction and quality of life of women with breast cancer. This review therefore addresses a very topical yet neglected area which takes into consideration the increasing use of adjuvant aromatase inhibitors in women with breast cancer and the importance of recognising and acknowledging the psychosocial impact of this treatment, in this case, sexual functioning, on this population.