Table 2. Pharmacological treatments of sexual dysfunction in young BC patients.
| Agent | Targeted sexual problem/dysfunction | Tested in cancer patients (Yes/No) | Level of Evidencea |
|---|---|---|---|
| Hormonal | |||
| Estrogens (transdermal estradiol; vaginal estradiol tablets) | Vulvovaginal atrophy and dryness; dyspareunia | Yesb | 1a |
| Testosterone (topical cream; transdermal patch) | Low sexual desire | Yesb | 1b |
| Tibolone | Sexual desire and arousal | Yesc | 2b |
| DHEA (intravaginal cream) | Vulvovaginal atrophy; sexual desire and arousal | Yes | Unknow |
| Non-hormonal | |||
| Flibanserin | Low sexual desire and distress | No | Unknow |
| Phosphodiesterase type 5 (PDE-5) inhibitors (sildenafil) | Genital arousal | No | 2b |
| Bremelanotide | Arousal | No | 1b |
| Phentolamine | Vulvovaginal lubrication | No | Unknow |
| Prostaglandins | Arousal | 2b | |
| Bupropion | Reduction of sexual dysfunction; depression | No | Unknow |
| L-arginine | Vasomotor symptoms; sexual desire | Yes | 2b |
aLevel of Evidence based on the classification of the Oxford Centre for Evidence-based Medicine—Levels of Evidence (March 2009) (http://www.cebm.net/?o=1025, last accessed on 15.04.2013); bIts use in BC cancer patients lacks long-term safety data and should be discussed on a case-by-case basis (46,47). Alternatives for vaginal dryness and dyspareunia include water-based lubricants and moisturisers; cIt should not be used in BC patients (one study closed prematurely due to safety concerns).