Improving Sexual Health With Medical Approaches
Sexual activity after diagnosis and treatment has benefits for your body, mind and soul. It can help you stay connected to yourself and to your partner, if you have someone in your life.
Many women who have had breast cancer report concerns about sexual health after treatment; nearly one-third feel lingering problems for years, sometimes decades.
If you experience any sexual side effects, talk them over with your healthcare providers. There are many safe, effective remedies to provide relief and improve your sexual satisfaction. You can also take self-care steps to improve your sexual health.
Before using any over-the-counter product, be sure to consult with your doctor, nurse or another member of your care team.
Vaginal Lubricants
After chemotherapy
or hormonal therapy, low estrogen can cause the vagina to become dry. This makes for painful penetration, or dyspareunia. Even rubbing and caressing the area outside the vagina can be painful. Low estrogen can also trigger burning, pain and itching in the vagina and contribute to ongoing urinary tract or yeast infections.
Vaginal lubricants can increase your comfort. They come as a liquid or gel and may be used before penetration or for sex play. Lubricants are usually applied to the vulva and in and around the opening to the vagina. They may also be used on the penis and on sex toys.
Use water- or silicone-based products. Over-the-counter lubricants include
- Astroglide
- Femglide
- Good Clean Love
- K-Y Sensitive
- SYLK Personal Lubricant
- Wet Original Gel Lubricant
Some advice on using vaginal lubricants:
- Gel lubricants that warm or cool, or have a scent or flavor, may irritate your tissues.
- Avoid petroleum jelly-based products that can harbor bacteria in your vagina and lead to infection.
- Petroleum jelly-based lubricants can break down the latex in condoms.
- This increases the risk of breaks or tears and makes condoms less effective as birth control.
- Do not use silicone-based lubricants with silicone sex toys. They will destroy the toys.
Vaginal Moisturizers
Unlike lubricants, vaginal moisturizers are used inside the vagina and not on the vulva. These products are used for daily comfort and not for sexual activity.
Generally, you insert an applicator of moisturizer 2 to 5 times a week to keep the tissues in your vagina hydrated and elastic.
Avoid products with fragrance. Look for those containing vitamin E or hyaluronic acid. You can also get these items in stores or online.
Over-the-counter moisturizers include
- Emerita Personal Moisturizer
- K-Y SILK-E
- Luvena
- Me Again Long Lasting Vaginal Moisturizer
- Replens
Vulvar Cream
An over-the-counter product, Neogyn Vulvar Soothing Cream is a hormone-free cream that restores vulvar tissue and eases painful penetration. It’s available online and in drug stores.
Vaginal Estrogens
Vaginal estrogens are hormone-containing creams, rings and tablets inserted into the vagina. They deliver estrogen in the local area, to restore vaginal tissues. These products may increase elasticity and lubrication to allow for easier penetration. Non-hormonal moisturizers and lubricants are often used alongside vaginal estrogens.
These estrogen delivery products are not FDA-approved for women who have had breast cancer, but some healthcare providers may prescribe vaginal estrogens “off-label” to treat vaginal dryness.
Many oncologists have strong reservations about vaginal estrogen use in women with a history of breast cancer, especially if you had hormone receptor-positive dis- ease. The body may absorb even small amounts of estrogen. Little research has been done on vaginal estrogens in women with breast cancer, so the impact is not known.
If you are considering off-label use of vaginal estrogens, have a frank talk with your care team. Weigh the possible risks and benefits, and ask your team’s feeling about safety. You may also be able to take part in clinical trials.
Vaginal Dilators
Vaginal dilators are rod-shaped inserts that can be put in the vagina. They gently stretch the vagina to maintain and increase elasticity of the walls. By slowly increasing the length and width of the vagina, dilators can make sex less painful.
They may also build your confidence in trying penetration by helping you learn to relax the muscles that surround your vagina.
Vaginal dilators are made of glass, plastic, silicone or rubber. They come in sizes from extra small to extra large. When selecting a dilator, choose one made of hypoallergenic material in a small size your body can easily fit. A healthcare provider with expertise in sexual concerns can suggest the type of dilator that would work best for you.
Some advice about using vaginal dilators:
- Use a water-soluble lubricant on your dilator and insert it carefully into your vagina.
- Leave it in place for 5 to 10 minutes a day, every day.
- Start with a small-size dilator. As it becomes easier to use, gradually use medium- and large-size dilators until you achieve comfort with a dilator that is close to the size of your partner’s penis and is easy to move around.
You can buy dilators in sex shops or online at
- Goodvibes.com
- MiddlesexMD.com
- Pureromance.com
- Vaginismus.com
Vibrators
A vibrator, or self-stimulator, is a small device that may be shaped like a dilator or a penis. It vibrates at different speeds to provide a pleasurable feeling and can be used for massage or sexual pleasure.
It’s common for both men and women to use vibrators during sexual activity. Vibrators can increase sexual pleasure and the ability to reach orgasm that may not be possible through penetration or use of the hand or mouth alone.
The thought of using a sex aid to stimulate yourself or enhance sexual pleasure with a partner may embarrass you, but vibrators are good for sexual health. They are thought to increase blood flow to the vagina and vulva. If your vibrator fits comfortably inside your vagina, it can also be used to stretch it instead of a vaginal dilator.
Vibrators can be purchased in sexual toy shops and online at Goodvibes.com and Pureromance.com.
