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Life Beyond Cancer - Sexual Issues for Women

Scroll through these topics or click on one to go directly to that content.

Vaginal Dryness

Vaginal dryness is caused by a low level of estrogen in your body.  This can be a result of chemotherapy, radiation, or a number of other factors. Because your body is in a state of having low levels of estrogen, the vagina and vulva (the external genital organs of the female including the clitoris) can be affected dramatically.

What can you do? The goal, in terms of sexual health, would be to restore the lubrication and elasticity that the vaginal area usually has when there is plenty of estrogen, but without using estrogen.

  • Use of water-based lubricants to the external vaginal area. Examples of lubricants that can be bought over-the-counter or at your local pharmacy are:
    -Astroglide
    -K-Y Liquid
    -Sylk
    -Wet
  • Use of vaginal moisturizers can be helpful. They are different from lubricants. They are used inside the vagina. This is a non-hormonal product and can be purchased over-the-counter. It is generally used 3-5 times a week and is placed up inside the vagina, regardless of sexual activity. It is used for moisturizing the tissue that makes up the vaginal canal. It helps hydrate the membranes and increase the elasticity or pliability of the vagina which can help minimize pain during intercourse.  An example of a vaginal moisturizer is Replens.

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Lack of Sexual Desire/Connection

Loss of libido, or sexual desire, is one of the most common complaints among women. Unresolved fatigue, depression and embarrassment about body image and possible appliances (colostomy, ileostomy) have a significant impact on sexual desire. There are no medications that are effective in restoring one’s sexual desire.

What can you do?
Books are a great way to start. Reading books together, as a couple, can facilitate healthy communication. Communicating with your partner is the best way to jumpstart your sexual desire. Other options include:

  • Start with what feels comfortable. Holding hands, cuddling, touching, and kissing is a great start.
  • Consider speaking to a stoma therapist if you have a colostomy or ileostomy
  • Consider speaking with a counselor or sex therapist as a couple, allowing for an impartial opinion
  • It’s common to feel uneasy about being naked in front of your spouse. Try using a special nightgown or clothing if that feels more comfortable to you, particularly if you are trying to conceal an ostomy bag.

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Painful Intercourse/Decreased Vaginal Elasticity

Painful intercourse and penetration are usually due to vaginal dryness and decreased elasticity of the vagina due to surgery, chemotherapy, radiation or a combination of these treatments. Whatever the reason, pain with sexual activity tends to create a cycle of fear and anticipation of pain that causes the muscles to tense up which, in turn, causes more pain. 

What can you do?

  • Use of water based lubricants to the external vaginal area.  Examples of lubricants that can be bought over-the-counter or at your local pharmacy are:
    -Astroglide
    -K-Y Liquid
    -Sylk
    -Wet
  • Use of vaginal moisturizers can be helpful. They are different from lubricants. They are used inside the vagina. This is a non-hormonal product and can be purchased over-the-counter. It is generally used 3-5 times a week and is placed up inside the vagina, regardless of sexual activity.  It is used for moisturizing the tissue that makes up the vaginal canal. It helps hydrate the membranes and increase the elasticity or pliability of the vagina which can help minimize pain during intercourse.  An example of a vaginal moisturizer is Replens.
  • Consider the use of graduated vaginal dilators. These are used to stretch the skin in order to maintain elasticity in the area. Stretching the area will help make a pelvic exam more comfortable, make sexual intercourse more comfortable and will allow you to feel more confident. Talk to your health care provider about this option. To learn more refer to the resources list provided at the end of this section.

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Altered Body Image

In our modern day, we are barraged with what society says is sexy and beautiful. Watching TV and seeing models with skinny bodies and youthful, flawless skin is what we see on a daily basis. How you feel about your body is extremely important and we tend to judge ourselves very harshly. Moving away from that unhealthy thinking is a start to feeling confident, whole and connected with yourself.

What can you do?

  • Consider allowing your partner to come to your appointments with you and be a part of the process.  Partners feel scared and out of control just as much as you do.
  • View pictures ahead of time at the surgeons office of what is possible for reconstruction so that you have a realistic expectation
  • Consider allowing your partner to see your body. This is a chance to share with your partner.  Chances are your partner has imagined far worse than what actually exists.
  • If you undergo chemotherapy and have been told that you will lose your hair, be prepared that you will also lose your pubic hair.
  • Consider counseling if you are feeling depressed or overwhelmed.  Talking about your feelings is a much healthier choice.
  • If you have a colostomy or ileostomy, consider seeing a stoma therapist for further help.
  • Consider a special nightgown or being partially clothed if you don't feel ready to show your naked body to your partner.

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Resources

Woman Cancer Sex by Katz, Anne

Sex Information and Education Council of the United Stateswww.siecus.com

Society for Sex Therapy and Researchwww.sstarnet.org

Vaginal Changes and Radiation: http://www.womentc.com/content.php?keyword=radiation

Vaginal Changes and Menopause: www.womentc.com/content.php?keyword=The%20postmenopausal%20vagina

Vaginal Dilators: http://www.mskcc.org/patient_education/_assets/downloads-english/293.pdf

Rekindling Desire: A Step by Step Program to Help  Low Sex or No Sex Marriages by McCarthy, M. & McCarthy, E.:

Discovering Your Sexual Style: The Key to Sexual Satisfaction by McCarthy, M. & McCarthy, E.

For Yourself:  The Fulfillment of Female Sexuality by Barbach, L.

 The New Love and Sex Over Sixty by Butler, R.N. & Lewis, M.J. (2002)

Intimacy After Cancer A Woman’s Guide by Kydd, S. & Rowett, D

National Center for Complementary and Alternative Medicine: www.nccam.nih.gov

The United Ostomy Associationwww.uoa.org

Livestrong: http://www.livestrong.org/Get-Help/Learn-About-Cancer/Cancer-Support-Topics/Physical-Effects-of-Cancer/Female-Sexual-Dysfunction

 

 

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