Sex Matters: Vaginal Dryness

By on August 6th, 2014 Categories: Sex Matters

Many women who have treatment for breast cancer develop early menopause or report that their menstrual cycles have stopped for 12 months in a row. Most women recognize that hot flashes and mood changes are associated with the menopause, but they don’t always identify vaginal dryness and painful sex as part of the constellation of symptoms they are experiencing as they move through the menopausal years.

Whether you’ve stopped your cycle as a direct result of chemotherapy or removal of your ovaries, or you have gone through menopause naturally, vaginal dryness can interfere with your quality of life.

When women transition through menopause, the level of estrogen in the body drops substantially. This lowered hormone level can affect the vaginal lining and cause thinning of the vulvar walls – vaginal atrophy. The vagina is very sensitive to estrogen levels, and when this declines, the lining can become thin, frail, pale, and less elastic. Common symptoms of vaginal dryness include irritation, pain, discharge, burning, and itchiness. In addition, many women may also suffer from painful intercourse, recurrent urinary infections, or repeat candida or bacterial vaginosis infections. The underlying problem may be an abnormal vaginal PH. With menopause and the decline or loss of estrogen, the vaginal PH may be altered, leading to all of these troublesome issues.

One of the consequences from living with vaginal dryness is painful intercourse. It’s not uncommon to have lowered sexual interest or drive if sex is painful. Dryness can impact the sensual intimacy between a couple, and women may avoid their partners if they are concerned that sex maybe painful or distressing. Many women diagnosed with breast cancer can get some relief from some simple solutions for this issue and should consider some of the over-the-counter products including vaginal moisturizers or lubricants.

Vaginal moisturizers help hydrate the vaginal tissue and help regain the ridges, elasticity, and pliability; they are used independently of sexual intercourse. Lubricants, on the other hand, are used during sexual play and can help during intercourse. Typically, both partners apply lubricant before intercourse. Some lubricants may need to be reapplied during sex.

Vaginal dryness is a serious – and common — problem for women who have breast cancer, but there’s no need to suffer in silence. There are safe, non-hormonal over-the-counter products that can help ease the symptoms.

Next time, we’ll do a deep dive into the actual product and practical suggestions to combat vaginal dryness. Have you experienced dryness, and if so, what have you tried to help ease the symptoms? Let us know in the comments area below. We also welcome your questions about vaginal dryness – we’ll choose some to answer in our upcoming August 20th column!

Michael L. Krychman, M.D.C.M., is the executive director of the Southern California Center for Sexual Health and Survivorship Medicine in Newport Beach, California. He is the former co-director of the Sexual Medicine and Rehabilitation Program at Memorial Sloan-Kettering Cancer. Dr. Krychman is also an American Association of Sexuality Educators, Counselors and Therapists (AASECT) certified sexual counselor. He is an associate clinical professor at the University of California, Irvine, Division of Gynecological Oncology, and the medical director of Ann’s Clinic, a high-risk program for breast and ovarian cancer survivors. His special interests include menopausal health, hormone therapy, sexual pain disorders, loss of libido, and chronic medical illness and its impact on female sexual function as well as breast cancer sexuality. Dr. Krychman is also a member of the Professional Advisory Board.


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