The Acceptability, Feasibility, and Efficacy (Phase I/II Study) of the OVERcome (Olive Oil, Vaginal Exercise, and MoisturizeR) Intervention to Improve Dyspareunia and Alleviate Sexual Problems in Women with Breast Cancer

Authors

  • Ilona Juraskova PhD, MPsych(Clin), BA(Hons),

    1. Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW, Australia
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  • Sherin Jarvis B App Sc (Physio),

    Corresponding author
    1. School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
    • Department of Endo-Gynaecology, The Barbara Gross Research Unit, Royal Hospital for Women, Sydney, NSW, Australia
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  • Kelly Mok MBBS,

    1. Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia
    2. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
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  • Michelle Peate PhD, MSciMed (RH&HG), GradDipSci, BSc(Bioinfo),

    1. Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia
    2. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
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  • Bettina Meiser PhD, BA(Psych), BAppSc,

    1. Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia
    2. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
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  • Benjamin C. Cheah PhD, MBiostat, BA, BSc(Hons),

    1. Neuroscience Research Australia, Sydney, NSW, Australia
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  • Shab Mireskandari DPsych (Counselling), Hon (Psych), BSc,

    1. Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW, Australia
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  • Michael Friedlander PhD, FRACP, MRCP, MBChB

    1. Department of Medical Oncology, Prince of Wales Hospital, Sydney, NSW, Australia
    2. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
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  • Financial support: The study was funded by a Project Grant from the Susan G. Komen Breast Cancer Foundation (ID POP 106306), United States, which supported Sherin Jarvis and Kelly Mok. Ilona Juraskova was supported by a Cancer Institute NSW Early Career Development Fellowship. Bettina Meiser was supported by a Career Development Award from the National Health and Medical Research Council of Australia (ID 350989) and a Cancer Institute NSW Career Development Fellowship.

Corresponding Author: Sherin Jarvis, B App Sc (Physio), Barbara Gross Research Unit, Royal Hospital for Women, Barker Street, Randwick, Sydney, NSW 2031, Australia. Tel: +61-2-9382-6564; Fax: +61-2-9382-6244; E-mail: Sherin.Jarvis@sesiahs.health.nsw.gov.au

Abstract

Introduction

Almost half of breast cancer survivors experience chronic sexual problems. Despite the negative effects of dyspareunia on physical and overall quality of life, sexual dysfunction remains underreported and undertreated in clinical practice. This is likely due to the paucity of evidence-based interventions to improve sexual functioning.

Aim

The study aims to prospectively evaluate the acceptability, feasibility, and efficacy of a novel intervention (Olive Oil, Vaginal Exercise, and MoisturizeR [OVERcome]) to improve sexual problems following breast cancer treatment.

Main Outcome Measures

Dyspareunia, sexual functioning, quality of life, distress, and pelvic floor muscles (PFMs) functioning were evaluated.

Methods

Twenty-five women with dyspareunia were instructed to perform pelvic floor muscle (PFM) relaxation exercises twice/day to prevent/manage PFM overactivity, apply a polycarbophil-based vaginal moisturizer three times/week to alleviate vaginal dryness, use olive oil as a lubricant during intercourse, and complete a weekly compliance diary. PFM relaxation training was administered by a physiotherapist at weeks 0 and 4, with follow-up at weeks 12 and 26. At each visit, women completed validated self-report questionnaires and the physiotherapist recorded objective measures of PFM functioning.

Results

OVERcome resulted in significant improvements in dyspareunia, sexual function, and quality of life over time (all P < 0.001). PFM relaxation training was reported to be effective (P ≤ 0.001). Maximum benefits were observed at week 12. Most women rated PFM relaxation exercises (92%), vaginal moisturizer (88%), and olive oil (73%) as helpful, indicating that the intervention was acceptable. Unexpectedly, six cases (11%) of vaginal stenosis were noted during initial screening.

Conclusions

This novel intervention is acceptable to patients with demonstrated efficacy in improving dyspareunia and sexual function following breast cancer. Delivery of the OVERcome intervention appears feasible in a clinical setting, providing a potential treatment for this important clinical issue. The unexpected number of observed cases of stenosis further highlights the underreporting of sexual problems in this population, deserving further exploration. Juraskova I, Jarvis S, Mok K, Peate M, Meiser B, Cheah BC, Mireskandari S, and Friedlander M. The acceptability, feasibility, and efficacy (Phase I/II study) of the OVERcome (Olive oil, Vaginal Exercise, and moisturizeR) intervention to improve dyspareunia and alleviate sexual problems in women with breast cancer. J Sex Med 2013;10:2549–2558.

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