Breast cancer survival is increasing. There are currently 2.5 million breast cancer survivors in the United States. Unfortunately, many women become menopausal as a result of treatment or discontinue estrogen therapy at time of diagnosis. That situation, plus disfigurement as a result of the treatment often impacts a woman’s sex life. Gynecologist Lauren Streicher, M.D. has a special interest in the problem and offers solutions to restore the sex life of breast cancer survivors.
Dr. Streicher notes that sexual problems occur in up to 90% women with breast cancer. Vaginal dryness as a result of hormonal changes, chemotherapy, tamoxifene, and aromatase inhibitors is the most common complaint. Unfortunately, however, most women, while frustrated and upset by this, do not broach the topic with their doctor. They are not aware there is anything they can do about it and accept it as “the price they pay to stay alive”
At a minimum, most women try a lubricant, but find that intercourse is still painful, or not even possible; thus, they abandon future attempts with a devastating effect on their relationship. Dr. Streicher notes that a number of options are available for women with breast cancer that they are not aware of, but will revitalize their ability to have comfortable intercourse. These options include:
- A silicone-based lubricant
- A local, vaginal estrogen
- Ospemifene
Dr. Streicher warns against water soluble lubricants and particularly any lubricants that contain propylene glycol. Propylene glycol can irritate vaginal tissues, particularly in women with vaginal dryness following breast cancer treatment. Many products are available that are silicone-based. Dr. Streicher recommends Wet Platinum because it provides long lasting lubrication and is widely available. If a woman feels uncomfortable about plunking a lubricant down at the checkout counter, consider purchasing online at Drugstore.com, which has a wide variety of products. Alternatively, send your husband or significant other out to make the purchase. Dr. Streicher notes that she finds that a number of women in her practice do not know how to properly apply the lubricant. It needs to apply to the interior of the vagina with the fingers or an applicator. Alternatively, your partner can apply it to his equipment.
Disfigurement following radiation and surgery can severely harm a woman’s sexual well-being. Our breast-oriented culture fuels that problem. These negative feelings can be overcome with counseling. Currently, breast surgeons are incorporating cosmetic surgery into the cancer surgery; thus, may women can come out of the entire surgical process with attractive breasts, perhaps even more attractive than they were before the surgery.
With her keen interest in women’s healthcare, Dr. Streicher has written a book on a procedure familiar to women, a hysterectomy. Her newly updated edition of “The Essential Guide to Hysterectomy: Advice from a Gynecologist on Your Choices Before, During, and After Surgery,” she reveals the following: What your doctor isn’t telling you; robotic hysterectomy and why it is becoming so popular; new nonsurgical ways to control heavy bleeding; the latest on hormone therapy, including bioidentical hormones; how to decrease your risk of uterine or ovarian cancer without removing your uterus or ovaries; new methods for treating fibroids; and a comprehensive guide to websites and resources.
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