Breast Cancer, Vaginal Dryness and Sex

Have you ever noticed sometimes Mother Nature plays cruel tricks on us? You and your spouse take a trip to that romantic island you’ve always wanted to visit only to discover, at the most intimate of moments, you have vaginal dryness and intercourse is painful. You are not alone. Over half of all women over 40 suffer from vaginal dryness, and more than likely, it may be due to lack of estrogen.

Many women experience loss of estrogen well before menopause, others after a hysterectomy. A drop in hormone levels also occurs if you’ve undergone treatment for estrogen-receptor positive (ER+) breast cancer. I can’t think of a single side effect of low estrogen that isn’t just plain rude and frustrating, and trust me… I’ve experienced them all. The one that bothers me most, however, is vaginal dryness. Physicians call it sexual dysfunction, but simply put, it is pain during intercourse due to vaginal dryness. So what do you do? Doctors are not always comfortable discussing this subject, and perhaps you’re shy about asking. Once again, I am your trusty lab rat.

Cosmetics companies are always telling women to “moisturize.” That doesn’t apply just to our face and hands. With age and lack of hormones our vaginal tissues become thin and dry. They no longer “self moisturize,” or lubricate with arousal, and need a little help to keep intercourse from being painful. As a result of intense pain, many women look for ways to avoid sex. That isn’t good for your marriage, or your immune system. A study by endocrinologist, Dr. Winifred Cutler, at Wilkes University in Pennsylvania, showed those who have sex once or twice a week showed 30% higher levels of immunoglobulin A, an antibody which is known to boost the immune system. Fortunately, there are a number of products on the market to soften and moisten vaginal tissues, but if you’ve had estrogen positive breast cancer, none of them may be the perfect solution.

While most of the following suggestions take a few weeks to see results, they are well worth the wait. Start by drinking eight large glasses of water a day followed by eating a balanced, healthy diet. Many women who eat a low-fat, high-carb diet don’t get the nutrients needed to make enough estrogen for vaginal lubrication. If, however, your breast cancer was estrogen positive, you want to avoid foods containing phytoestrogens like soy and flax.

For some women, Vitamin E oil works relatively well and for others, personal lubricants bring immediate relief. I have tried them all and Replens Single-Use Vaginal Applicators and Wet Naturals Barely Bare (there are many Wet Naturals, but use only Barely Bare) work best for me. All are water-based, which means the products are not sticky and gooey, and are paraben and estrogen free, which is important for me to avoid since my breast cancer was estrogen positive. Our bodies turn parabens—methylparaben, ethylparaben, propylparaben and butylparaben—into estrogen. Start reading labels and avoid products containing parabens. Some personal lubricants, like K-Y and Vaseline may be your tried and true favorites, but can cause unwanted friction, which can lead to more pain. Replens applicators and liquid and Wet Naturals Barely Bare may be a little harder to find than other alternatives, but you can purchase them at the RETAIL THERAPY store on BreastCancerSisterhood.com. http://www.breastcancersisterhood.com/retailtherapy.htm

For best results, insert one Replens Applicator before sex—the earlier the better—in order to give the moisturizer a chance to soften your vaginal tissues. The instructions say the moisture lasts for up to three days, but at that, I was still having painful intercourse. A female gynecologist told me to use a Replens applicator everyday, whether I was having sex or not, to keep the tissues moisturized. Also inserting the applicator at night gives tissues the chance to absorb the moisture without trickling out and wetting your clothes like it does if you insert one in the morning.

While the right lubricant does makes a difference, intercourse may still be painful. If this is the case you might want to pour, yes, I said pour, the lubricant directly into your vagina. Do not be shy about adding more as you go along, and make sure your partner stays well lubricated as well. If you find intercourse is still painful, certain sexual positions are better than others. Experiment.

Regular sexual activity has been shown to improve vaginal atrophy by stimulating blood flow to the area. If you have vaginal dryness and haven’t had estrogen positive breast cancer, ask your doctor about low-dose vaginal estrogen tablets, the vaginal ring or the cream. Also, there has been a lot of talk in the last few years about bioidentical hormones, but that is a lengthy discussion for another day. Bottom line, since my breast cancer was estrogen positive, I don’t want to ingest, rub or look at ANY form of estrogen.