Q: Allison: Does tamoxifen have any effect on sexual drive? I seem less interested since my surgery.

A: Leslie Schover, Ph.D.: That’s a good question. There is not much evidence that tamoxifen decreases sex drive. In studies of women with breast cancer, tamoxifen does not appear to cause sexual problems. In the breast cancer prevention trials, however, women who were at risk for breast cancer had a few more problems on tamoxifen compared to a placebo or sugar pill.

Marisa Weiss, M.D., president and founder: But I thought libido in that study was actually a little bit higher?

Leslie Schover, Ph.D.: The problems really weren’t with sex drive, but with vaginal dryness.

Marisa Weiss, M.D., president and founder: Part of the problem that women have with loss of sexual interest after breast cancer treatment, while on tamoxifen, may come from the lingering side effects of early menopause due to chemotherapy.

Leslie Schover, Ph.D.: Some chemotherapy effects on sexual desire may have to do with changes in the hormones called androgens. Testosterone is one androgen. In women, about one half of the androgens in the blood stream come from the ovaries. When chemotherapy damages the ovaries, women’s androgen levels go down. This could affect a woman’s desire for sex; however, we do not know whether it is safe to give testosterone replacements to women who are breast cancer survivors.