Archive for August, 2011

Early Chemotherapy Can Compromise Female Fertility

A number of chemotherapy or anticancer medications may compromise a woman’s fertility.

Now it appears that the earlier the cancer diagnosis, the higher the risks for later infertility.

Some chemotherapy medicines, like those in the alkylating agents group, can cause infertility.

These types of chemotherapy medicines can be used to treat many different kinds of cancer, not just cancers that affect the reproductive organs.

Chemotherapy mostly causes infertility by reducing the number of eggs in your ovaries or by causing early menopause.

Many women who receive chemotherapy and radiation for Hodgkin’s disease go into premature menopause because of damage to their eggs or follicles.

Those exposed to both therapies suffer more damage than those who receive only one therapy.

Focusing on longer-term, age-specific outcomes associated with chemotherapy, researchers at the University of California at San Francisco have found that the younger a woman is when diagnosed with cancer, the more likely she will experience early menopause.

Key findings from a survey of more than 1,000 women in a California cancer database, now available online in the journal Cancer, include:

* From 5-10% of women reported acute ovarian failure, which increased significantly with age at diagnosis.

* The incidence of infertility increased significantly with age at diagnosis.

For example, for women with Hodgkin’s disease, 18% were infertile at age 20 compared to 57% at age 35.

* Using age as a predictor of early menopause in non-Hodgkin lymphoma, more than half of women age 20 at diagnosis experienced menopause early compared to one in 6 who were age 35 at diagnosis.

“We noted proportions of infertility among cancer survivors that appear considerably higher than those in the general United States population,” said lead author Joseph Letourneau, MD.

Not all women who are having cancer treatment have the opportunity to talk with a fertility specialist before beginning treatment.

Yet there are several options to preserve a woman’s fertility, including freezing embryos, eggs, or tissue from her ovaries before she goes for cancer treatment.

If you have received a cancer diagnosis, particularly if you had cancer in your 20s, ask your oncologist how you can preserve your fertility.

Does Mind Over Body Delay Premature Ejaculation?

Premature ejaculation is a common sexual dysfunction found among men with infertility.

Between 50-75% of men with infertility report having problems maintaining an erection long enough to ejaculate.

Researchers have linked premature ejaculation to a variety of conditions, including anxiety, a malfunctioning ejaculation reflex, prostate disease, and chemical imbalances in the brain, as well as possibly to genetics.

Sex therapy can help couples with emotional issues about sex, and also teach “stop-start” techniques that help men learn more control.

While famous sex researchers Masters and Johnson reported early success with behavioral therapy, a new systematic review found it’s not so easy to teach men to control their bodies with their minds.

The new Cochrane Collaboration review of 4 trials involving 253 premature ejaculation patients finds the effectiveness of psychological interventions for the treatment of premature ejaculation to be “weak and inconsistent.”

Medical therapy may be a better way to go.

Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), paroxetine (Paxil), or fluoxetine (Prozac), can be effective in treating premature ejaculation.

That’s because one of the side effects of these drugs is to delay ejaculation.

A low dose of an SSRI several hours before sexual intercourse may be enough to improve a man’s symptoms.

However, SSRIs may have a negative impact on semen quality.

Studies at Weill Cornell Medical College in New York have shown that SSRIs can reduce semen volume and increase damage to the DNA in sperm, which is called DNA fragmentation.

Or you may prefer to use a topical anesthetic cream applied to the penis to delay ejaculation.

These creams contain lidocaine or prilocaine to dull sensations on the penis.

A man applies the cream just before intercourse and wipes it off when his penis has lost enough sensation to delay ejaculation, which can take up to 45 minutes, and puts on a condom.

However, some men and women say using topical anesthetic creams reduces their genital sensitivity and their sexual pleasure.

For fertility purposes, as long as the man is capable of ejaculating, the couple could also use artificial insemination to achieve a pregnancy.