Breast Cancer Survivors & Sexual Dysfunction

Now more than ever, women confronting breast cancer are prevailing in their campaign against the disease. That’s the magnificent news. Unfortunately, many breast cancer survivors struggle to lead a post-treatment life they recognize—one resembling their life prior to their illness. Dr. Katherine Williams, chief gynecologist-obstetrician (OBGYN) of the Covington-based Center for Women’s Health, has now opened the Southern Institute for Women’s Sexual Health (SIWSH) to not only aid breast cancer survivors but help all women suffering from sexual dysfunction.

“I want to improve breast cancer survivors’ quality of life and that includes healing any sexual dysfunction they may be experiencing,” explains Williams. “For survivors to achieve quality intimacy again, many women must have their breast reconstructed and their health return, but they lose their sexual being. I want to provide a place where they can learn to regain that and truly live again.” For too long, whether because of society or culture, women have internalized their physical intimacy obstacles, remarked Williams. “There could not be a worse time for this phenomenon,” Williams said, “than when a woman wrestles with the physical trauma and mental anguish that accompanies taxing cancer treatments such as chemotherapy, radiation or surgery.”

The National Cancer Institute (NCI) cites research that suggests at least 50 percent of breast cancer patients “experience long-term sexual dysfunction,” and yet there is little indication that sexual counseling factors into oncology treatment, or with any of the patient’s healthcare professionals. This is despite the evidence that dysfunction issues may persist well past the first couple of years of disease-free survival, and may “remain constant and fairly severe or even continue to increase” into the future, reports NCI. “I think we as the medical community for so long have been focused on finding the cure for cancer, and with great results—I have more and more patients who are 10-, 15-, 20-year survivors,” affirmed Williams. “Now, progressing forward, it is time we talk about how to live with cancer. I think this is the moment to encourage more dialogue. It is time for women to stop suffering.”

Breast cancer patients have increased susceptibility to sexual dysfunction issues because of the nature of their disease and its treatment, explained Williams. “Their hormones are often diminished because they have had their ovaries removed as a preventative measure, or as risk reduction for recurrence of breast cancer,” Williams said. “Also, [hormones may be diminished] if their ovaries were overwhelmed by the chemotherapy, forcing them into early menopause, or as a result of the medication they are taking.” Moreover, body changes arising from surgery—such as a mastectomy for example—may lead to disturbances of a woman’s self image, clinically known as Body Dysmorphic Disorder.

“They just don’t feel like a sexual female anymore,” she clarifies.

The conditions Williams witnesses most among her breast-cancer surviving patients include:
– Pain with intercourse, often severe, preventing an ability to have sex;
– The absence of, or a diminished sex drive;
– Depression or anxiety from underactive reproductive hormones, stress, Body Dysmorphic Disorder or any combination of these.
With SIWSH, Williams and her partners offer expert, curative strategies to assist all women including breast cancer survivors over these hurdles associated with sexual dysfunction.

“The best course of treatment is a comprehensive history and evaluation that allows the doctor to understand the whole patient. This cannot be done with a simple office visit, period,” resolved Williams. “In order to formulate the best treatment, plan I start most consults with a discussion that allows the patient to tell me their story and verbalize their problems. I do an exam that gives me a preliminary diagnosis and I order a battery of tests specific to female dysfunction.” Williams also provides a 140-part questionnaire—something her patient can complete at home, in privacy—which she reviews before the patient’s next visit. “This is a vital element in all of my strategies – listening to my patient’s individual needs,” expressed Williams.

“On the second visit, I perform a Vulvoscopy to examine the area of concern with a microscope, allowing me to discern any physical abnormalities,” said Williams. “I review their questionnaire with them. All of this provides me with better understanding of the patient, her history and medical condition, in order to formulate the best treatment plan.”

“Again, you can only do that once you understand the patient,” declares Williams. “And you can only understand them when you promote openness and honesty. The extensive questions and health information I assimilate is designed to best help the patient.” She concludes with an illustrative example.

“There are some breast cancer patients who come to see me and they are so miserable,” empathizes Williams. “They tell me they are very unhappy—the hot flashes, the menopause—all of it. I will ask them, ‘What is the scariest thing to you: not living the life you had before or getting cancer again?’ When they say, ‘Not living the life I had before,’ I discuss multiple options to assist this patient, encompassing the risk and benefits related to all plans of care.”

Williams believes most treatment plans apply a multi-faceted approach—one that endows strategies specific to each individual woman’s needs—and which she roots in three main tiers: physical therapy, medical therapy and psychotherapy. Her ambition to equip patients with every necessary resource during the healing process motivated Williams to recruit a well-respected oncologist, Dr. Jay Saux, to SIWSH. Saux, much beloved in the oncology community because of his excellence and dedication, provides risk counseling for patient treatment relative to their diagnosis, explained Williams. This employs a robust arsenal of expertise allowing Williams and her SIWSH team to restore patients’ sexual health.

Dr. Williams is a board certified OBGYN and fellow of the International Society of Women’s Sexual Health. Currently, she accepts patients at two locations: Center for Women’s Health (104 Innwood Drive, Covington, LA 70433) and at the Center for Restorative Breast Surgery (1717 St. Charles Avenue, New Orleans, LA 70130.) For additional information or to schedule a new patient appointment, call 985-871-0707.

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