This exciting new application could lead to millions of women preventing breast cancer through tamoxifen. The FDA has recently approved this drug for reduction of the risk of breast cancer in women who are at high risk for the development of breast cancer based on their family history.

Oral chemotherapy with Nolvadex (tamoxifen citrate), a widely used chemotherapeutic agent for patients with breast cancer, has caused vaginal dryness in about a third of the patients. Relaxation of the clitoral cavernosal smooth muscle appears to be regulated mostly by the nitric oxide (NO) pathway. Recent reports from Goldstein, Krane, and colleagues' have shown in the animal model in the laboratory that contraction of clitoral cavernosal and vaginal smooth muscle is regulated by adrenergic nerves. Since the arousal phase of female sexual function depends on increased blood flow into both the vaginal wall and the clitoris, any understanding of the basic physiology of those tissues may have predictive value on the role of Viagra. First of all, is the same mechanism that we saw in the erectile tissue in the penis occurring in the erectile tissue of the clitoris and in the smooth muscle tissue of the vaginal wall? Based on our understanding of the mechanism of action of Viagra with its enhancement of the nitric oxide (NO) mechanism of smooth muscle relaxation that allows for increased blood flow, a couple of basic questions come to mind.

One of the most common questions we hear today is: Will Viagra work for females as well as for males? The Young Women's Christian Association (YWCA) has developed a national program for post-op cancer patients, ENCORE (Encouragement, Normality, Counseling, Opportunity, Reaching Out, Energies Revived). The American Cancer Society's Reach to Recovery program offers support to breast cancer patients to help them adjust to their disease and treatment. This side effect of increased lubrication can be beneficial, obviously, to sexual activity. In these women, some reported that Nolvadex causes increased vaginal lubrication and possibly a clear discharge. On the other hand, tamoxifen evidently improves vaginal lubrication in some women, according to reports of women who were already suffering from vaginal dryness due to menopause. Although the frequency of sexual activity did not increase, satisfaction did improve and more closely approached levels of satisfaction prior to mastectomy.

Women who sought reconstruction after a mastectomy, in one study, were found to be more comfortable with their sexuality than before reconstruction. A number of studies have revealed that women who sought breast reconstruction were exhibiting evidence of positive coping and asserting effective problem solving behavior.'