Have you ever noticed sometimes Mother Nature plays cruel tricks on us? You and your spouse take a trip to that romantic island you’ve always wanted to visit only to discover, at the most intimate of moments, you have vaginal dryness and intercourse is painful. You are not alone. Over half of all women over 40 suffer from vaginal dryness, and more than likely, it may be due to lack of estrogen.
Many women experience loss of estrogen well before menopause, others after a hysterectomy. A drop in hormone levels also occurs if you’ve undergone treatment for estrogen-receptor positive (ER+) breast cancer. I can’t think of a single side effect of low estrogen that isn’t just plain rude and frustrating, and trust me… I’ve experienced them all. The one that bothers me most, however, is vaginal dryness. Physicians call it sexual dysfunction, but simply put, it is pain during intercourse due to vaginal dryness. So what do you do? Doctors are not always comfortable discussing this subject, and perhaps you’re shy about asking. Once again, I am your trusty lab rat. <PREVIEWEND>
Cosmetics companies are always telling women to “moisturize.” That doesn’t apply just to our face and hands. With age and lack of hormones our vaginal tissues become thin and dry. They no longer “self moisturize,” or lubricate with arousal, and need a little help to keep intercourse from being painful. As a result of intense pain, many women look for ways to avoid sex. That isn’t good for your marriage, or your immune system. A study by endocrinologist, Dr. Winifred Cutler, at Wilkes University in Pennsylvania, showed those who have sex once or twice a week showed 30% higher levels of immunoglobulin A, an antibody which is known to boost the immune system. Fortunately, there are a number of products on the market to soften and moisten vaginal tissues, but if you’ve had estrogen positive breast cancer, none of them may be the perfect solution.
While most of the following suggestions take a few weeks to see results, they are well worth the wait. Start by drinking eight large glasses of water a day followed by eating a balanced, healthy diet. Many women who eat a low-fat, high-carb diet don’t get the nutrients needed to make enough estrogen for vaginal lubrication. If, however, your breast cancer was estrogen positive, you want to avoid foods containing phytoestrogens like soy and flax.
For some women, Vitamin E oil works relatively well and for others, personal lubricants bring immediate relief. I have tried them all and Replens Long-Lasting Vaginal Moisturizer Applicators, Replens Long-Lasting Liquid and Wet Naturals Barely Bare (there are many Wet Naturals, but use only Barely Bare) work best for me. All are water-based, which means the products are not sticky and gooey, and are paraben and estrogen free, which is important for me to avoid since my breast cancer was estrogen positive. Our bodies turn parabens—methylparaben, ethylparaben, propylparaben and butylparaben—into estrogen. Start reading labels and avoid products containing parabens. Some personal lubricants, like K-Y and Vaseline may be your tried and true favorites, but can cause unwanted friction, which can lead to more pain. Replens applicators and liquid and Wet Naturals Barely Bare may be a little harder to find than other alternatives, but you can purchase them at the RETAIL THERAPY store on BreastCancerSisterhood.com. http://www.breastcancersisterhood.com/retailtherapy.htm
For best results, insert one Replens Long-Lasing Moisturizer Applicator before sex—the earlier the better—in order to give the moisturizer a chance to soften your vaginal tissues. The instructions say the moisture lasts for up to three days, but at that, I was still having painful intercourse. A female gynecologist told me to use a Replens applicator everyday, whether I was having sex or not, to keep the tissues moisturized. Also inserting the applicator at night gives tissues the chance to absorb the moisture without trickling out and wetting your clothes like it does if you insert one in the morning.
While the right lubricant does makes a difference, intercourse may still be painful. If this is the case you might want to pour, yes, I said pour, the lubricant directly into your vagina. Do not be shy about adding more as you go along, and make sure your partner stays well lubricated as well. If you find intercourse is still painful, certain sexual positions are better than others. Experiment.
Regular sexual activity has been shown to improve vaginal atrophy by stimulating blood flow to the area. If you have vaginal dryness and haven’t had estrogen positive breast cancer, ask your doctor about low-dose vaginal estrogen tablets, the vaginal ring or the cream. Also, there has been a lot of talk in the last few years about bioidentical hormones, but that is a lengthy discussion for another day. Bottom line, since my breast cancer was estrogen positive, I don’t want to ingest, rub or look at ANY form of estrogen.
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Previous Comments
sophie commented on 06-Jul-2010 10:39 AM Thank you, Brenda, for your wonderful advice.
My cancer was estrogen positive. I am blessed enough to have found a really good doctor that practices integrative medicine. He explained to me that there are 3 types of estrogens: 2 bad ones, and a good one called estriol.
I've been on estriol cream, but unfortunately have developed an allergy to the cream base.
Off to go buy some Replens now :-)
My cancer was estrogen positive. I am blessed enough to have found a really good doctor that practices integrative medicine. He explained to me that there are 3 types of estrogens: 2 bad ones, and a good one called estriol.
I've been on estriol cream, but unfortunately have developed an allergy to the cream base.
Off to go buy some Replens now :-)
Brenda Coffee commented on 11-Jul-2010 05:06 PM Jody,
Love your comments! It's a blog in itself & so true. I have a hunch the world believes cancer treatments only involve loosing hair & nausea. They have no clue what's in store until they actually embark down this long road that never ends.
Thanks for the confirmation on Replens. I'd love to interview the nurse at MD Anderson. Sounds like she has a wealth of knowledge in the area.
XOXOXOXO,
Brenda
Love your comments! It's a blog in itself & so true. I have a hunch the world believes cancer treatments only involve loosing hair & nausea. They have no clue what's in store until they actually embark down this long road that never ends.
Thanks for the confirmation on Replens. I'd love to interview the nurse at MD Anderson. Sounds like she has a wealth of knowledge in the area.
XOXOXOXO,
Brenda
Debbie commented on 11-Jul-2010 05:33 PM Great post Brenda and fantastic comment by Jody. There are too many side effects to mention and I'm with Jody, if I had heard it all at once I might have bolted for the door and never looked back.
I just want to add my two cents. Hubby and I use a lubricant called H2O by Sliquid. It has no parabens, is non-toxic and is vegan/not-tested on animals:) It is easy to use from a little squeeze bottle.
You can also go to cosmeticsdatabase.com to look up personal care items that are rated for toxicity. They may have some other choices there as well.
Thanks for the frank post and thanks to Jody too:)
I just want to add my two cents. Hubby and I use a lubricant called H2O by Sliquid. It has no parabens, is non-toxic and is vegan/not-tested on animals:) It is easy to use from a little squeeze bottle.
You can also go to cosmeticsdatabase.com to look up personal care items that are rated for toxicity. They may have some other choices there as well.
Thanks for the frank post and thanks to Jody too:)
Brenda Coffee commented on 11-Jul-2010 09:15 PM Hi Debbie,
Two great suggestions about a topic we need more info. I will be ordering some H2O. Sliquid. Great name. You almost know what they make before they tell you! So great to hear from you, girlfriend:)
XOXOXOXO,
Brenda
Two great suggestions about a topic we need more info. I will be ordering some H2O. Sliquid. Great name. You almost know what they make before they tell you! So great to hear from you, girlfriend:)
XOXOXOXO,
Brenda
Anonymous commented on 13-Jul-2010 05:57 PM Hey there. If you have a moment, I'd like you to take a look at a project I am the designer for. It's a t-shirt I designed to raise money for my co-worker's "Race for the Cure" team. It's really taken off and people love it. Trying to get the word out.
Check me out at www.helpbustbreastcancer.com
Thanks!
Craig
Check me out at www.helpbustbreastcancer.com
Thanks!
Craig
Dixie commented on 07-Sep-2010 08:42 PM Hi, it's me again. boy did I need to read this. just about given up but will be trying everyone's suggestions.
Dixie
Dixie
Pam commented on 19-Sep-2010 04:58 PM Brenda,
I was thrilled when a family member introduced me to your website - she showed me an article in the Austin newspaper on you around Father's Day, and I read your article in the San Antonio paper on Tuesday. What a delight you are, and you inspire, educate, motivate and spport all of us with your wisdom, your sense of humor, and your determination.
I live here in Boerne and have a wonderful family and friends who are with me each step of the way on this journey. I have been extremely fortunate.
Thanks again and keep those articles coming - I have shared them with others too - so the hits on your website continue to grow!
Fondly,
Pam
I was thrilled when a family member introduced me to your website - she showed me an article in the Austin newspaper on you around Father's Day, and I read your article in the San Antonio paper on Tuesday. What a delight you are, and you inspire, educate, motivate and spport all of us with your wisdom, your sense of humor, and your determination.
I live here in Boerne and have a wonderful family and friends who are with me each step of the way on this journey. I have been extremely fortunate.
Thanks again and keep those articles coming - I have shared them with others too - so the hits on your website continue to grow!
Fondly,
Pam
Brenda Coffee commented on 19-Sep-2010 05:01 PM Pam,
Boerne's a small community. I'm sure we've passed one another in the grocery store. You'll know it's me because I'm the one who talks to herself, esp when I read labels. Hope to hear from you again.
XOXOXO,
Brenda
Boerne's a small community. I'm sure we've passed one another in the grocery store. You'll know it's me because I'm the one who talks to herself, esp when I read labels. Hope to hear from you again.
XOXOXO,
Brenda
Melanie commented on 19-Sep-2010 05:03 PM Hi Brenda, As a cancer survivor, you can attest to the physical, emotional and financial impact that cancer and its treatments can have on an individual – one of my best girlfriends finished treatment for breast cancer (she is 26) in October, and I forwarded her a link to your blog, because she’s been complaining of some lasting side effects and I think she would appreciate your latest post.
Go to Brenda's Blog homepage | Go to top of page
This is a great post about the "side effect no one warned us about."
But then I think: imagine an oncologist telling you, upon diagnosis,
"OK, then. We're going to give you chemotherapy, you cool w/that? Hair loss, nausea, some puking, maybe a lot of puking. Mouth sores, and oh yeah, some people get nerve loss in hands and feet, but not usually a problem. Then we're going to put you under our radiation machine and see if we can make your skin adhere to bone! Wow. Sorta gross for some, but not always. What do you think about that? You may have some lymphadema and need physical therapy, and oh yeah, the sex life you used to have? It's going to be a whole lot different. But no worries. Once we put you on tamoxifen you aren't going to care."
You know what? If I'd heard the entire bundle in one day I would have had the surgery and said, dudes, you keep the rest:)
I don't know what you imagined about breast cancer treatment or long term affects but hair loss was the smallest of all things that turned into a problem for a long term.
For vaginal dryness there is a nurse practitioner at MD Anderson who has about five different treatment plans for the problem. She's awesome. She comes in and says, "have we had the vagina talk yet? Yes? Good." She said the Replens (once routine) twice a week, Monday and Thursday.
And I agree, at night. When you first start using it there will be more (not less) discharge as dry tissue will be eliminated. I also find that a good dose of Omega 3's are good for seem to help a lot of different symptoms (especially in lowering cholesterol for me -- who knew?)
Great job. If I hear anything else or see any further info I'll pass it on.
Jody