RECLAIMING INTIMACY AFTER CANCER

Young women with cancer have special issues not often addressed with diagnosis, related to sexuality and relationships. Chemotherapy can affect ovarian function and cause premature menopause. Who wants to have a vagina of an 80 year old when you are not? Cancer treatments affect self-esteem, sexuality and relationships. Most side effects of treatment are temporary and life becomes more normal after the treatment period. Sex and sexuality are important parts of everyday life. Sexuality affects our zest for living, our self image and relationships with other. Yet patients often do not talk about the effects of treatment or their sex lives due to embarrassment, feelings of being exposed, and it being an awkward topic. When you first think of restarting sexual activity you may be afraid it will be painful. I would venture to guess that your first session of lovemaking was not what you expected. Have faith your vagina is a very forgiving organ. In other words, I would recommend you use it or lose it. You can bring your body back to a normal functional state and bring back pleasure as well, with a few simple choices. Cancer treatments often reduce the amount of moisture your vagina produces. You may need to use extra lubricants to make intercourse more comfortable. Choose water base or natural oil based lubricants, avoid gels with perfumes, coloring, spermicides or flavors as the chemical can irritate already sensitive skin. Common brands include K-Y Jelly, Astroglide or Lubrin. Be aware of herbal extracts such as aloe or lavender. These may cause irritation and in some cases, allergic reactions. Also, avoid any of the warming gels as these can cause burning. Replens and K-Y Liquidbeads are moisturizers that can be used 2-3 times a week to help keep the vagina moist. Astroglide and Lubrin last longer than most lubricants. Olive oil and vegetable oil are natural oil based lubricants that are less expensive and are not irritating to you or your partner. Crisco shortening may be used as a moisture barrier. Vitamin E gel caps can also be used as a moisturizer but be aware they may stain. Some women do well with vaginal hormones. They come in gel, cream, ring and tablet form. Talk to your physician regarding these options. Vaseline, skin lotions and other oil based lubricants are not good choices as they may cause irritation and yeast infections. If latex condoms are used they can be damaged by petroleum products. Condoms or gels that contain nonoxynol-9 can be irritating to already dry fragile tissues. Even if you use a vaginal moisturizer you may still need to use a lubricant before and during sex. Make sure you feel aroused and use large amounts of lubricant prior to intercourse. If not well lubricated prior to intercourse you may experience dryness and pain. The risk of bladder infection is also increased if you have dryness or pain. Let your partner know if any type of touching causes pain. Try a position that lets you control the depth of penetration and movement. Vaginal dilators are an option, especially after radiation of the pelvis, cervix or vagina. Using dilators keeps your vagina from getting tight with scar tissue after treatments. Dilators work best when used early after radiation or surgery to prevent shrinkage. If you go for many months without intercourse, it is important to use a dilator to keep your vagina in shape. Premature menopause because of cancer treatment can cause hot flashes and night sweats making one sticky and sweaty. Most are not desperate for the same when having sex. Tell your partner what you want and need. Communication, communication, communication is the key to building a successful relationship and returning to normal after cancer treatment.