title: 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.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors: Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW, Australia.
authors: Ilona
authors: I
authors: Juraskova
authors: Sherin
authors: S
authors: Jarvis
authors: Kelly
authors: K
authors: Mok
authors: Michelle
authors: M
authors: Peate
authors: Bettina
authors: B
authors: Meiser
authors: Benjamin C
authors: BC
authors: Cheah
authors: Shab
authors: S
authors: Mireskandari
authors: Michael
authors: M
authors: Friedlander
mesh_terms: D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D004414:Dyspareunia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004643:Emollients / Q000009:adverse effects / Q000627:therapeutic use*; D005081:Exercise Therapy / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008055:Lipids / Q000009:adverse effects / Q000627:therapeutic use; D054327:Lubricants / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009126:Muscle Relaxation; D000069463:Olive Oil; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000503:physiopathology*; D010938:Plant Oils / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D012725:Sexual Behavior / Q000187:drug effects*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000187:drug effects* / Q000503:physiopathology; D014622:Vaginal Creams, Foams, and Jellies
chemical_list: D004643:Emollients; D008055:Lipids; D054327:Lubricants; D000069463:Olive Oil; D010938:Plant Oils; C085472:Replens; D014622:Vaginal Creams, Foams, and Jellies
keywords: Breast Cancer; Dyspareunia; Pelvic Floor Muscle Relaxation Exercises; Sexual Functioning; Vaginal Dryness; Vaginal Lubricant/Moisturizer