Nurturing Intimacy with Vaginal and Sexual Health Challenges after Breast Cancer
Written by Grace Tew, an undergraduate student at UNCW and a Public Health Intern at Going Beyond the Pink.
*Disclaimer: This post contains affiliate links.
Intimacy has great health benefits such as lowering stress levels, decreasing rates of loneliness, reducing the risk of mortality and can help improve your overall health. However, it’s no secret that the hardships from Breast Cancer can impact intimacy in relationships. Typically when people think of intimacy they automatically assume sexual relations, but intimacy is much more than that. It’s the level of comfort that you have with your partner to communicate emotionally, physically, sensually and can then lead to a healthier, more vibrant emotional connection and sex life.
Understanding the Intimate Aftermath of Cancer Treatment:
To begin to understand how to nurture intimacy in your partnerships, it’s important to understand the possible side effects from cancer treatments for both men and women:
Sexual Health Changes During/Post Cancer Treatment:
The following changes can occur for men:
• Inability to get or maintain an erection
• Pain during sex
• Decrease or loss of sexual desire
• Ejaculation and orgasm problems which may include premature ejaculation or urination during ejaculation
The following changes can occur for women:
• Vaginal dryness
• Pain during sex
• Inability or difficulty having an orgasm
• Numbness
• Decrease or loss of sexual desire
• Early menopause
Why does cancer treatment affect intimate and sexual health?
For Men:
Chemotherapy can lower testosterone levels and sex drive during the treatment period, but should not affect the ability to have an erection.
External-beam radiation therapy could damage blood vessels or nerves, if these are damaged in the pelvic area it may lead to difficulty in erection, called erectile dysfunction. It can also cause skin reactions, swelling, pain in the breast/chest, hair loss, sore throat, extreme tiredness, lymphedema, change in breast shape, size and color, and tenderness over the ribs.
Hormone therapy can cause a decrease in sex drive due to the lower levels of testosterone. This can also cause difficulty in achieving and maintaining an erection.
Medicines that are suggested to treat pain, depression, nerves and blood vessels can have effects on overall sex drive as well.
For Women:
Chemotherapy lowers the estrogen levels and can cause the ovaries to not produce enough hormones and release eggs. With these hormonal changes patients may experience hot flashes, irregular/no periods, vaginal tissue and dryness, which can cause pain or discomfort during sexual intercourse.
Hormone Therapy can also cause lower levels of estrogen, many of the same symptoms as chemotherapy can arise.
Radiation Therapy can cause skin reactions, swelling, pain in the breast/chest, hair loss, sore throat, extreme tiredness, lymphedema, change in breast shape, size and color, and tenderness over the ribs.
Surgery such as a double mastectomy, single mastectomy or a lumpectomy might lead to the way you view your own body. There are options for reconstruction post-surgery, talking with your doctor will allow you to learn the most for what is best for you.
Medicines to handle the pain from breast cancer treatment can lead to lower interest in sex, prescriptions to treat depression may also have an impact on libido as well.
Overall health problems like heart disease, high blood pressure, diabetes, and smoking can also promote changes in sexual health before, during and after treatment. Being able to recognize these side effects and understanding what treatments can make you or your partner feel can help communicate with your partner and increase the comfortability with one another.
How can you help relieve the discomfort of intimate and sexual health side effects from cancer treatment?
Pain and Numbness
Get in tune with how your body is feeling: Take the time to explore your own body so you can figure out where touch is enjoyable or where it isn’t.
Have open communication with your partner: Being open and honest about worries of pain during sex with your partner may release tension and worry for both of you.
Be open to trying new ways to be intimate: Reading books with your partner that are erotic and touching each other intimately will use less energy and make it easier to avoid painful or sensitive areas.
Explore different positions: When being intimate, experiment different positions until you find one that is the most comfortable for you. Focusing on positions that will provide relief in pressure of sensitive areas.
Try pain relief: As painful areas heal, pain should start to relieve in the area. Pain medications like ibuprofen can be helpful in relieving pain, however you may have to plan ahead of being intimate or having sex so the pain relief can kick in. If pain relief medications do NOT help, please contact your GP for further information on your options.
Fatigue
Try to get up and move around: It sounds counterintuitive, but increasing the amount of exercise can fight how fatigued you are.
Discuss options with your treatment team: Let your treatment team know that you’re fatigued, sometimes the cause of fatigue can be treated through medication or supplements.
Remove the pressure: Spending time with your partner with no sexual expectation can aid in fatigue. Having open communication prior to treatments can help so there aren't any misconstrued expectations. A great way to have physical intimacy when you’re tired is holding hands or even just touching feet.
Menopausal Symptoms
Talk with your GP about your symptoms: First and foremost, communicate openly with your physician. They are there to help you figure out how to tackle menopausal symptoms, or they may be able to refer you to someone who specializes in menopause.
Have access to a fan: When going through menopause, hot flashes and night sweats can start to happen. Having a fan to help keep the air flow moving can be helpful.
Relaxation Techniques: There are multiple ways to help reduce stress! Some people enjoy visualization, distractions and yoga to help reduce stress and anxiety. Another great relaxing tool is being mindful, focusing on what’s happening right NOW, to avoid your mind from wandering.
Pelvic Floor Exercises: During menopause, sometimes women experience bladder problems. Pelvic floor exercises can help improve bladder control, and most of the time these exercises can be done sitting in a chair.
Maintaining a Well-balanced Diet: Having a well rounded diet can help avoid weight gain and fight against bone and joint problems, along with osteoporosis from the drop in estrogen levels.
Vaginal Dryness and Irritation
Talk with your doctor about these symptoms: The side effects may not always be discussed by treatment teams, it’s important to advocate for yourself to find relief. They can also help prescribe medications such as pessaries (https://www.ucsfhealth.org/education/pessaries), tablets, creams and hormone-based treatments safe for breast cancer.
Vaginal moisturizers: These products are typically applied with a small, dissolvable block that is entered in the vagina. It can be bought over the counter or prescribed through your doctor. They can be used every few days, but with more consistency you will find the best relief.
Vaginal Lubricants: Lubricants have a shorter time of relief than moisturizers, but are intended to help in preventing uncomfortable friction or pain during intercourse and intimacy. They are available as pessaries or tubes of liquid/gel and can be used along with moisturizers for more relief.
Pelvic Floor Exercises: Not only are these movements helpful for menopausal symptoms, but it’s great for increasing blood flow to the vaginal area. It can help aid in relaxing muscles used during sex and intimacy to reduce pain.
Intercourse and masturbation: Only try this if it is comfortable for YOU. The benefits from these actions can stimulate blood flow to the pelvic region and can help maintain its resilience and elasticity.
A product we love by Desert Harvest is great for breast cancer patients because it’s all natural with no added estrogen or phytoestrogens: Click Here to check it out.
Getting back to sex and intimacy:
When you have decided that it is YOUR time to increase or resume sexual activity, you may want to focus on your partnership and remove distractions. This time is personal, sensitive and intimidating due to the changes your body has had from breast cancer and treatment. Here are some tips that we suggest for getting back to it:
Start New! This time is not for comparison, be patient with yourself, it’s okay to take time and learn your new body.
Don’t rush! Not only take time to get secure with your new body, take the time to move slowly. Consider what levels of intimacy you’re wanting to explore and if you have the energy for it. By doing this you can plan ahead and take pain medication or ensure that you have the right products for the most pleasant experience.
Create a calming environment! When deciding to be intimate, being in relaxed conditions can help boost your confidence. Try finding lighting that is cozy, or music that is peaceful, even aromatherapy can help ensure a sensual experience.
Intimacy and sexual health issues are common in cancer patients and survivors. You aren’t alone in this experience. If addressing the sexual health and intimate impacts of treatment for cancer is important to you, there are resources that can help. Here are some options for further information:
Duke Cancer Survivorship Clinic & Sexual Health Clinic
A Better Normal: Your Guide to Rediscovering Intimacy After Cancer by: Tess Deveze. Click here to check her book out!
BreastCancer.org: Sexual Health During and After Breast Cancer
