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Topic: I WANT MY MOJO BACK!

Forum: Sex & Relationship Matters —

A safe place to talk candidly about how your romantic relationships and/or your sex life has changed following your diagnosis and treatment.

Posted on: Oct 17, 2004 12:45PM - edited Feb 9, 2016 12:04PM by Moderators

Mena wrote:

Hey girls,

You know, this loss of libido thing is just unnacceptable. I was in the chat room earlier today and mentioned it and man, you should've heard how many of us are experiencing this problem. I promised the ladies I'd post my rant, so here it comes (or....doesn't ).

If bc were a man's disease, not only would there be a cure for bc by now, but certainly there'd be a plethora of non-hormonal therapies available for whatever the female version is of "erectile dysfuntion". I don't think I'm exaggerating. I'll make the damn commercials myself (no pride here lol).

Prior to the news of my recurrence/mets (August) my husband and I had a phenomenal sex life. I absofreakinlutely loved making love to my husband. (Btw, I'm 43; and as part of tx for mets, I was chemically oopherized with Zoladex and take Femara daily).

I still enjoy loving my love. Emotionally, spiritually, mentally, I do. Even physically I still like it. It's just not rockin' my world, as they say, like it used to. I miss that. And I refuse to accept this as acceptable. It is not. If the genders were reversed, this would be the first &%$#* problem they'd address! Well, ok, the second.

I know the clinical reasons for the low libido, but there's got to be something out there for us that's not contraindicated with treatment. Here's what I've tried so far: a Zen approach; a "go w/the flow" attitude; a "get started and it'll all just kick in" mindset; a "try not to think about it at all" focus; et al.

I'm interested in hearing what the rest of you have to say about this matter, and I know it is an intimate one. But we're all sisters and I do hope some of you will share your experiences and whatever help you've found for missing mojo.

Thanks for letting me vent. God Bless.

Mena

****************************Addition from February 4, 2016***********************************

Hi All,

We've gone through a lot (not all) of the pages on this topic, and tried to compile your suggestions.

Do you feel that this is a complete list of what has been discussed here? Please help us make a comprehensive list of your ideas!


Member suggestions for helping the libido:

Watch romantic movie or soft-porn on Netflix

Romantic music

Watch porn or visit short videos on Tumblr, YouTube, or other internet site

A little wine, or other substance to help relax (e.g. medical marijuana)

Sexual photos

Massage and massage oils

Literotica: Erotic/sexual stories as an alternative to images

Super sexy lingerie or fun clothing

Have partner practice foreplay and/or oral sex

Practice masturbation on a regular basis

Mindfulness, i.e. focus on what your five senses are experiencing in the moment --To keep your thoughts from dwelling on cancer and scars


Member suggestions to improve vaginal moisture:

Coconut oil works best as a moisturizer (freeze small balls to make suppositories)

Vitamin E suppositories

Almond oil

Replens long-lasting moisturizer

Luvena vaginal moisturizer

Shea butter melted into olive oil at a 2:1 ratio

Cocoa butter

Olive oil

Gynatrof gel

DHEA vaginal suppositories

Tip to use an applicator to insert moisturizers and apply a few times a week.


Member suggestion for lubrication during sexual activity:

Astroglide Natural (free from glycerin, fragrance, flavorings, and hormones)

Slippery Stuff (free from glycerin and parabens)

K-Y warming Jelly

K-Y Sensual Silk Liquid (paraben-free)

K-Y Liquibeads

K-Y UltraGel (paraben-free)

Astroglide, X (silicone-based)

Platinum Wet (silicone-based)

Replens silky smooth lubricant (silicone-based)

Sliquid natural lubricants (free from DEA, gluten, glycerine, glycerol, parabens, PEG, propylene glycol, sorbitol & sulphates)


Additional member suggestion to reduce pain:

Topical Lidocaine solution for use at the entrance of the vagina


Member suggestion for sex toys:

Vibrators (e.g. Hitachi Magic Wand, Pink Dot Vibe, Pocket Rocket, the Rabbit)

Dildos for pleasure, to stretch the entrance, prevent vaginal atrophy and strengthen muscles


Member suggestion for estrogen or hormone-based treatments

(MUST discuss first with oncologists as not typically recommended for women who have had breast cancer)

Vagifem® (estradiol vaginal tablets) inserts

Testosterone patch or gel

ESTRING® (estradiol vaginal ring)

ESTRACE® CREAM (estradiol vaginal cream)

Scream Cream - contains a combination of prescription and non-prescription components described as blood flow enhancers and vasodiolators to apply to your clitoris (adding here, as it contains a bit of Testosterone- 0.25mg per dose)


Other member suggestions:

Kegel exercises to strengthen pelvic muscles

Pelvic physical therapy

Dilators to stretch the skin in your vaginal area and re-train the pelvic floor muscles to relax

Observe which antidepressant you take, and make necessary changes

MonaLisa Touch: A minimally invasive laser treatment for vaginal rejuvenation.

Easier if she "goes first".

Regular activity is important.

Read the book, COUPLES CONFRONTING CANCER: KEEPING YOUR RELATIONSHIP STRONG, by Fincammon & Bruss, published by the American Cancer Society.

Share this thread with your husband/lover to create a new bond of intimacy, normalize what others are going through and open communication.

Take a look at this resource: https://sexualityresources.com

Dx 8/8/2004, IDC, Stage IV, Grade 3, 1/20 nodes, mets, ER+/PR+, HER2+
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Page 135 of 137 (4,096 results)

Posts 4021 - 4050 (4,096 total)

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Dec 20, 2018 11:25PM kmpod wrote:

I'm sorry to hear that macb04. The incontinence is adding insult to injury. Are you still on an AI?

I found that when I was on Arimidex, even if I hadn't been affected physically, my desire was totally and utterly gone. Sex was written out of my agenda.

I truly wasn't expecting my libido to return when I went off the medication, but I'm really happy it has.

kathy Dx 7/15/2011, IDC, 2cm, Stage IIA, Grade 3, 0/4 nodes, ER+/PR+, HER2-
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Dec 21, 2018 01:53AM - edited Dec 21, 2018 01:53AM by macb04

kmpod, I never used an AI, just 9 terrible months with tamoxifen. I had ovarian cysts, severe insomnia and volcanic rages that made me into a person just barely holding on to my sanity. ****<shudder>****

I do have some interest in sex, just kind of academically, never feeling much lust, if you know what I mean. I keep hoping I will figure some way to get it back. Makes me sad.

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Dec 30, 2018 01:53PM Shoregirl wrote:

A Bio-Identical progesterone cream is all I need to stave off mp associated vag dryness and hot flashes. It doesn't do anything for my libido though. I am hoping once my revisions are complete I will get my mojo back.... I do love coconut oil though. I put it in my morning coffee and whip it in my blender with a bit of cream.... nice and frothy like a latte!

I am not advocating the progesterone cream for everyone by any means though...check with your dr. I had trip neg dcis so no concern about HRT for me. But even before bc dx, my dr said the progesterone cream Is safer than estrogen.

Faith, Hope & Love, the greatest of these is Love 1st Cor 13:13 Dx 12/2/2016, DCIS, Right, 6cm+, Stage 0, Grade 3, 0/2 nodes, ER-/PR-, HER2- (IHC) Surgery 1/27/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/25/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 11/29/2017 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2018 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Dec 31, 2018 08:08PM chicopeach57 wrote:

A few years ago my MO had prescribed Estrace for the pain during intercourse, it worked great. Supplemented with coconut oil, but would still having tearing. GYN prescribed clobetasol, a steroid cream, with approval from MO. Have not torn since! I use about half a gram of Estrace about every three days. Initially used the clobetasol twice a day for a week or two, have cut back to once a day. Will cut back a bit more, do not want to use more than I need to. As far as libido, that takes work, an open mind and an understanding SO and batteries

A strong person is not the one that does't cry. A strong person is one who is quiet and sheds tears for a moment and then picks up her sword and fights again. Ash Sweeney Dx 11/13/2013, IDC, Right, 1cm, Stage IIIA, Grade 3, 4/11 nodes, ER+/PR+, HER2- Surgery 11/22/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 12/13/2013 AC Chemotherapy 2/28/2014 Taxol (paclitaxel) Radiation Therapy 5/19/2014 Breast Hormonal Therapy 5/23/2014 Femara (letrozole) Surgery 12/9/2014 Reconstruction (right)
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Jan 1, 2019 08:12PM runor wrote:

Batteries .. ha ha ha! All I want for Chrsitmas is some c cells. Maybe D cells if the libido is really in the basement. Good luck ladies. Just google some pics of Jason Momoa and dream on.....

Dx 3/23/2017, IDC, Left, 2cm, Stage IIB, Grade 2, 0/1 nodes, ER+/PR+, HER2- Surgery 4/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Radiation Therapy 7/5/2017 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jan 2, 2019 12:59AM macb04 wrote:

chicopeach, just watch out for thinning of vaginal mucosa associated with Clobetasol Steroid Cream. I had been prescribed topical steroids like you years ago by my GYN, following a very severe yeast vagininitis caused by a 15 hour flight a week after antibiotics . It made everything way, way worse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908482/

Vulvar Skin Atrophy Induced by Topical Glucocorticoids

Elisabeth Johnson, Pamela Groben, [...], and Denniz Zolnoun

Additional article information

Abstract

Steroid induced skin atrophy is the most frequent and perhaps most important cutaneous side effect of topical glucocorticoid therapy. To date, it has not been described in vulvar skin. We describe a patient with significant vulvar skin atrophy following prolonged steroid application to treat vulvar dermatitis. The extensive atrophy in the perineum resulted in secondary 'webbing' and partial obstruction of genital hiatus and superimposed dyspareunia. Prolonged topical steroids may result in atrophic changes in vulvar skin. Therefore, further research in clinical correlates of steroid-induced atrophy in the vulvar region is warranted.

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Jan 2, 2019 03:16AM chicopeach57 wrote:

Macb04, wish they had stated the concentration of the steroids in the article. I noticed this was from 2012 so they could have tweaked those levels. I will watch the use and keep on eye on things. Thank you for the article

A strong person is not the one that does't cry. A strong person is one who is quiet and sheds tears for a moment and then picks up her sword and fights again. Ash Sweeney Dx 11/13/2013, IDC, Right, 1cm, Stage IIIA, Grade 3, 4/11 nodes, ER+/PR+, HER2- Surgery 11/22/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 12/13/2013 AC Chemotherapy 2/28/2014 Taxol (paclitaxel) Radiation Therapy 5/19/2014 Breast Hormonal Therapy 5/23/2014 Femara (letrozole) Surgery 12/9/2014 Reconstruction (right)
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Jan 2, 2019 01:46PM zjrosenthal wrote:

At 75 I still mourn the total loss of libido. I am on Tamoxifen for 10 years and will be 82 when done, if I live that long. My hubby has been very understanding of my lack of "passion" and I am able to creatively meet his needs. Meanwhile I am going to do the best I can to accept things as they are. My chemo oncologist has forbidden any use of hormones and lubricants do nothing for my dryness. Love, Jean

Dx 7/2014, IDC, Left, 3cm, Stage IIB, Grade 3, 3/3 nodes, ER+/PR-, HER2+ (FISH) Surgery 8/11/2014 Lumpectomy: Left; Lymph node removal: Left, Sentinel Chemotherapy 9/8/2014 AC Targeted Therapy 11/3/2014 Herceptin (trastuzumab) Targeted Therapy 11/3/2014 Perjeta (pertuzumab) Chemotherapy 11/3/2014 Taxol (paclitaxel) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 2/19/2015 Lymph node removal: Left, Underarm/Axillary Radiation Therapy 3/16/2015 Breast, Lymph nodes Dx IDC, 3cm, Stage IIB, Grade 3, 3/3 nodes, ER+/PR-, HER2+
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Jan 2, 2019 05:11PM - edited Jan 2, 2019 05:12PM by macb04

zjrosenthal, sounds like your doc is very old school. Vaginal Estrogen has very little effect on blood levels, but can make a huge difference to vaginal lubrication and health. Women with postmenopausal vaginal dryness and atrophy have more risk of UTI as well.

Even mainstream breast cancer management allows Vaginal Estrogen for help with Vaginal atrophy. Just a thought.


Find an OBGYN
The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer

Committee Opinion

Number 659, March 2016

(Reaffirmed 2018)



Committee on Gynecologic Practice
This Committee Opinion was developed by the American College of Obstetricians and Gynecologists' Committee on Gynecologic Practice. Member contributors included Ruth Farrell, MD. This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.


PDF Format

The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer

ABSTRACT: Cancer treatment should address female-specific survivorship issues, including the hypoestrogenic-related adverse effects of cancer therapies or of natural menopause in survivors. Systemic and vaginal estrogen are widely used for symptomatic relief of vasomotor symptoms, sexual dysfunction, and lower urinary tract infections in the general population. However, given that some types of cancer are hormone sensitive, there are safety concerns about the use of local hormone therapy in women who currently have breast cancer or have a history of breast cancer. Nonhormonal approaches are the first-line choices for managing urogenital symptoms or atrophy-related urinary symptoms experienced by women during or after treatment for breast cancer. Among women with a history of estrogen-dependent breast cancer who are experiencing urogenital symptoms, vaginal estrogen should be reserved for those patients who are unresponsive to nonhormonal remedies. The decision to use vaginal estrogen may be made in coordination with a woman's oncologist. Additionally, it should be preceded by an informed decision-making and consent process in which the woman has the information and resources to consider the benefits and potential risks of low-dose vaginal estrogen. Data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms.

Recommendations and Conclusions

The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions:

  • Nonhormonal approaches are the first-line choices for managing urogenital symptoms or atrophy-related urinary symptoms experienced by women during or after treatment for breast cancer.
  • Among women with a history of estrogen-dependent breast cancer who are experiencing urogenital symptoms, vaginal estrogen should be reserved for those patients who are unresponsive to nonhormonal remedies.
  • The decision to use vaginal estrogen may be made in coordination with a woman's oncologist. Additionally, it should be preceded by an informed decision-making and consent process in which the woman has the information and resources to consider the benefits and potential risks of low-dose vaginal estrogen.
  • Data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms.
Background

Oncologic care providers are increasingly recognizing that cancer treatment should address female-specific survivorship issues, including the hypoestrogenic-related adverse effects of cancer therapies or of natural menopause in survivors. Obstetrician–gynecologists and other health care providers frequently face the challenge of understanding and addressing these issues among an increasing cohort of women cancer survivors who experience urogenital symptoms, either from cancer therapy or physiologic menopause. Systemic and vaginal estrogen are widely used for symptomatic relief of vasomotor symptoms, sexual dysfunction, and lower urinary tract infections in the general population. However, given that some types of cancer are hormone sensitive, there are safety concerns about the use of local hormone therapy in women who currently have breast cancer or have a history of breast cancer (1, 2). This document will focus on the use of low-dose vaginal estrogen in women with estrogen-dependent breast cancer.

Nonhormonal methods, including moisturizers, lubricants, and topical anesthetics, are first-line approaches for treating urogenital symptoms or atrophy-related urinary symptoms experienced by women during or after treatment for breast cancer (3, 4). However, for some women, these approaches may have a limited and temporary effect on symptoms and quality of life (5, 6). Vaginal estrogen therapy has been shown to provide women with symptomatic relief of urogenital symptoms associated with perimenopause and menopause (3). Generally, vaginal estrogen delivers lower doses of hormone compared with those formulations developed to provide systemic relief of vasomotor symptoms and, thus, offer a different approach to the management of urogenital symptoms among these patients.

Low-Dose Vaginal Estrogen Preparations and Serum Estrogen Levels

There are three main commercially available preparations of vaginal estrogen in the United States: 1) cream, 2) ring, and 3) tablet (see Table 1 for suggested regimens). (Although there are other forms available, such as compounded vaginal estrogen products, there are concerns regarding the risks of variable composition and potency and the lack of efficacy and safety data [7].) Vaginal estrogen delivers a low dose of hormone to the local vaginal tissue with minimal systemic absorption. Vaginal creams include a 17β-estradiol vaginal cream and a conjugated estrogen cream. The only vaginal tablet product currently available in the United States contains 10 micro-grams of estradiol hemihydrate. Although there are two vaginal rings on the market, only the 17β-estradiol (commonly referred to as estradiol) silastic vaginal ring delivers low-dose hormone to the vaginal tissues. The second product, the estradiol acetate ring, provides systemic levels of hormone and is not discussed in this document.

Studies show that use of low-dose vaginal estrogens does not result in sustained serum estrogen levels exceeding the normal menopausal range; the lowest rates of systemic absorption are found in the ring and the tablet (815). When used at the appropriate dose, estradiol creams also deliver a low dose of hormone. Because of the heterogeneity of the estrogens in the formulation, data regarding the use of conjugated equine estrogen cream are less definitive compared with the data for estradiol cream. In addition, delivery of a set dose of estrogen is more variable with the creams in contrast to the tablet or ring. Thus, data regarding estradiol levels associated with vaginal creams have greater variability compared with tablet or ring formulations.

The Use of Vaginal Estrogen by Women With a Current or Prior History of Breast Cancer

Data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms (16). A nested case–control analysis of a cohort study of women with breast cancer who either did or did not use vaginal estrogen showed no increase of recurrence in vaginal estrogen users (17). In another study, the risk of recurrence in women who used vaginal cream was not increased, irrespective of the total dose prescribed (18).

Concerns remain about recurrence risk with use of vaginal estrogen in women with breast cancer who use aromatase inhibitors. Specifically, the threshold for systemic estrogen levels associated with breast cancer recurrence risk has yet to be determined (19). Some authors note that even a small increase in systemic estradiol levels may have a detrimental effect on recurrence risk and that more data are needed before recommendations can be made regarding the use of vaginal estrogen among this population (16, 20). Typically, aromatase inhibitors decrease circulating estradiol levels from 20 pg/mL to less than 1–3 pg/mL (20, 21). Studies have demonstrated an initial increase of serum estradiol with the use of low-dose vaginal estrogen (estradiol ring or the 25-microgram estradiol tablet) among women taking an aromatase inhibitor, though these levels were not sustained over time and increased cancer recurrence was not noted (11).

The use of vaginal estrogens may be appropriate for women with urogenital symptoms who use tamoxifen (22). Low and temporary increases of plasma estrogen do not appear to increase recurrence risk in women using tamoxifen because of a competitive interaction with the estrogen receptor (16). Because of these effects, women on aromatase inhibitors who experience urogenital symptoms refractory to nonhormonal approaches may benefit from the short-term use of estrogen with tamoxifen to improve symptoms, followed by a return to normal aromatase inhibitor therapy for the duration of the treatment course (20).

Conclusion

Nonhormonal approaches are the first-line choices for managing urogenital symptoms or atrophy-related urinary symptoms experienced by women during or after treatment for breast cancer. Among women with a history of estrogen-dependent breast cancer who are experiencing urogenital symptoms, vaginal estrogen should be reserved for those patients who are unresponsive to nonhormonal remedies. Treatment should be individualized based on each woman's risk–benefit ratio and clinical presentation. The decision to use vaginal estrogen may be made in coordination with a woman's oncologist. Additionally, it should be preceded by an informed decision-making and consent process in which the woman has the information and resources to consider the benefits and potential risks of low-dose vaginal estrogen. When the decision is made to use vaginal estrogen, it should be prescribed at the lowest dose to affect vaginal symptoms and for a limited period until symptoms are improved.

References
  1. Rippy L, Marsden J. Is HRT justified for symptom management in women at higher risk of developing breast cancer? Climacteric 2006;9:404–15. [PubMed] [Full Text]
  2. Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Menopause 2004;11:11–33. [PubMed]
  3. Management of menopausal symptoms. Practice Bulletin No. 141. American College of Obstetricians and Gynecol-ogists. Obstet Gynecol 2014;123:202–16. [PubMed] [Obstetrics & Gynecology]
  4. Goetsch MF, Lim JY, Caughey AB. Locating pain in breast cancer survivors experiencing dyspareunia: a randomized controlled trial. Obstet Gynecol 2014;123:1231–6. [PubMed] [Obstetrics & Gynecology]
  5. Loprinzi CL, Abu-Ghazaleh S, Sloan JA, vanHaelst-Pisani C, Hammer AM, Rowland KM Jr, et al. Phase III randomized double-blind study to evaluate the efficacy of a polycarbophil-based vaginal moisturizer in women with breast cancer. J Clin Oncol 1997;15:969–73. [PubMed]
  6. Suckling JA, Kennedy R, Lethaby A, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD001500. DOI: 10.1002/14651858.CD001500.pub2. [PubMed] [Full Text]
  7. Compounded bioidentical menopausal hormone therapy. Committee Opinion No. 532. American College of Obste-tricians and Gynecologists. Obstet Gynecol 2012;120:411–5. [PubMed] [Obstetrics & Gynecology]
  8. Lasley BL, Santoro N, Randolf JF, Gold EB, Crawford S, Weiss G, et al. The relationship of circulating dehydroepiandrosterone, testosterone, and estradiol to stages of the menopausal transition and ethnicity. J Clin Endocrinol Metab 2002;87:3760–7. [PubMed] [Full Text]
  9. Schmidt G, Andersson SB, Nordle O, Johansson CJ, Gunnarsson PO. Release of 17-beta-oestradiol from a vaginal ring in postmenopausal women: pharmacokinetic evaluation. Gynecol Obstet Invest 1994;38:253–60. [PubMed]
  10. Mitchell ES, Woods NF, Mariella A. Three stages of the menopausal transition from the Seattle Midlife Women's Health Study: toward a more precise definition. Menopause 2000;7:334–49. [PubMed]
  11. Wills S, Ravipati A, Venuturumilli P, Kresge C, Folkerd E, Dowsett M, et al. Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator. J Oncol Pract 2012;8:144–8. [PubMed] [Full Text]
  12. Rigg LA, Hermann H, Yen SS. Absorption of estrogens from vaginal creams. N Engl J Med 1978;298:195–7. [PubMed]
  13. Pschera H, Hjerpe A, Carlstrom K. Influence of the maturity of the vaginal epithelium upon the absorption of vaginally administered estradiol-17 beta and progesterone in postmenopausal women. Gynecol Obstet Invest 1989;27:204–7. [PubMed]
  14. Santen RJ, Pinkerton JV, Conaway M, Ropka M, Wisniewski L, Demers L, et al. Treatment of urogenital atrophy with low-dose estradiol: preliminary results. Menopause 2002;9:179–87. [PubMed]
  15. Simunic V, Banovic I, Ciglar S, Jeren L, Pavicic Baldani D, Sprem M. Local estrogen treatment in patients with urogenital symptoms. Int J Gynaecol Obstet 2003;82:187–97. [PubMed] [Full Text]
  16. Ponzone R, Biglia N, Jacomuzzi ME, Maggiorotto F, Mariani L, Sismondi P. Vaginal oestrogen therapy after breast cancer: is it safe? Eur J Cancer 2005;41:2673–81. [PubMed]
  17. Le Ray I, Dell'Aniello S, Bonnetain F, Azoulay L, Suissa S. Local estrogen therapy and risk of breast cancer recurrence among hormone-treated patients: a nested case-control study. Breast Cancer Res Treat 2012;135:603–9. [PubMed]
  18. O'Meara ES, Rossing MA, Daling JR, Elmore JG, Barlow WE, Weiss NS. Hormone replacement therapy after a diagnosis of breast cancer in relation to recurrence and mortality. J Natl Cancer Inst 2001;93:754–62. [PubMed] [Full Text]
  19. Trinkaus M, Chin S, Wolfman W, Simmons C, Clemons M. Should urogenital atrophy in breast cancer survivors be treated with topical estrogens? Oncologist 2008;13:222–31. [PubMed] [Full Text]
  20. Kendall A, Dowsett M, Folkerd E, Smith I. Caution: vaginal estradiol appears to be contraindicated in postmenopausal women on adjuvant aromatase inhibitors. Ann Oncol 2006;17:584–7. [PubMed] [Full Text]
  21. Biglia N, Peano E, Sgandurra P, Moggio G, Panuccio E, Migliardi M, et al. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study. Gynecol Endocrinol 2010;26:404–12. [PubMed] [Full Text]
  22. Management of gynecologic issues in women with breast cancer. Practice Bulletin No. 126. American College of Obstetricians and Gynecologists. Obstet Gynecol 2012;119:666–82. [PubMed] [Obstetrics & Gynecology]

Copyright March 2016 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

Requests for authorization to make photocopies should be directed to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400.

ISSN 1074-861X

The American College of Obstetricians and Gynecologists
409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920

The use of vaginal estrogen in women with a history of estrogen-dependent breast cancer. Committee Opinion No. 659. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;127:e93–6.

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Jan 31, 2019 04:23PM Trvler wrote:

Jean, Why not seek a second opinion? You don't HAVE to go to that doctor. I am also on a low does of topical estrogen.

Allison Dx 1/16/2015, ILC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- Dx 2/26/2015, ILC, Left, 4cm, Stage IIIA, Grade 2, 2/2 nodes, ER+/PR+, HER2- Chemotherapy 3/24/2015 AC + T (Taxol) Surgery 9/1/2015 Mastectomy; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Radiation Therapy 10/15/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 1/1/2016
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Feb 2, 2019 12:00PM TuesdayStar wrote:

I have barely begun to read this thread as it is super long going back to 2004. But I am really worried that I will lose my libido permanently.

I have always had a very healthy sex life and sexual response. It would be miserable to me if the best hope I had for a sex life is just using lubricants so it doesn't hurt. I want to enjoy it not just be medically able to do it

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Feb 2, 2019 12:11PM coachvicky wrote:

Tuesday ... You have options. That is what I have learned from this site.

I understand your fear. I could climax from nipple stimulation. When I lost them, I thought my pleasure was over and I have discovered it is not.

Please look into the Juliet Laser Treatment and the Mona Lisa Treatment.

Best wishes,

Coach Vicky

Dx 6/2016, DCIS/IDC, Both breasts, Stage IIA, Grade 3, ER+/PR+, HER2+ (FISH) Dx 6/7/2016, LCIS/DCIS/IDC, Right, 4cm, Stage IIA, Grade 3, ER+/PR+, HER2+ (FISH) Surgery 7/11/2016 Mastectomy; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/21/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 8/22/2016 Herceptin (trastuzumab) Surgery 1/20/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 2/22/2017 Prophylactic ovary removal Hormonal Therapy 4/4/2017 Arimidex (anastrozole) Surgery 10/19/2017 Surgery Targeted Therapy
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Feb 3, 2019 07:45PM Mominator wrote:

Has anyone tried Revaree?

I'm seeing the ads and it promises:

"Revaree is made of hyaluronic acid, a molecule that is naturally produced throughout the body and plays a significant role during cell development, wound healing, and regeneration. In the case of vaginal dryness, Revaree works by attracting and retaining moisture in the vaginal cell lining, creating a healing environment for thinning and damaged skin to provide lasting, hormone-free relief. The molecules inside Revaree can absorb up to 1,000 times their own weight in water, which helps keep vaginal cell tissue hydrated and rejuvenated. Hyaluronic acid has been rigorously studied in multiple clinical trials and is shown to be safe and side-effect free, with no effect on estrogen levels."

Sounds promising. Has anyone tried it? Any comments?

Mominator, BRCA2+, STK-11 VUS, wife, mom to 3 children of various special needs, musician, volunteer. My Mom dx DCIS age 62, ILC stage IIIA age 79; Mom just passed 2/28/18. My Grandmother died of ovarian cancer age 48. Friend to Lori M, died 5/25/16. Surgery 11/10/2015 Prophylactic mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/17/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/29/2017 Reconstruction (left): Silicone implant
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Feb 4, 2019 12:19PM jaycee49 wrote:

Mom, I have used two products with hyaluronic acid, both of which I learned about on this thread. Premeno Duo is one. It is a suppository that is really easy to use and very expensive. I just ran out and was looking for a good price which I rarely find. Amazon has it for $36 for 10 ovules (suppositories). The other is called Hyalo Gyn. It is a gel that comes with applicators. I've never preferred that application method but would use it if pushed by symptoms. I bought three tubes for $75. If you bought less than three tubes, it cost more per tube. I think you have to buy it from the manufacturer. That product was suggested by someone on this thread per her gyn. I have it but have never used it. Maybe the Revaree would be cheaper. I saw that when I googled hyaluronic acid but didn't notice the price. Lots of skin moisturizing products have it, too.

Janet (dx with MS at 41, slows me down some) Dx 4/25/2014, IDC, 3cm, Stage IIB, Grade 2, 1/18 nodes, ER+/PR+, HER2+ Surgery 6/4/2014 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Targeted Therapy 8/4/2014 Herceptin (trastuzumab) Chemotherapy 8/4/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 10/1/2014 Chest wall Hormonal Therapy 2/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 3/25/2016, IDC, Left, Stage IV, metastasized to bone/lungs, Grade 2, 1/18 nodes, ER+/PR+, HER2- (FISH) Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole)
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Feb 4, 2019 01:04PM anotherNYCGirl wrote:

Mominator, - My gyn gave sample of Revaree to me. It was easy to use and not uncomfortable (as many products are for me). I still have a supply of Hyalogyn, which was what my onc suggested, so I will use that up first. The Revaree is preferable to me, but more expensive, so I'll have to decide. In the mean time, coconut oil is always the best price and also comfortable and doesnt burn at all.

Dx 1998, DCIS, Stage 0 Surgery 3/17/1998 Lumpectomy: Left Dx 6/2000, ILC, Stage IA, 0/3 nodes, ER+/PR+, HER2- Surgery 7/10/2000 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/31/2000 CMF Hormonal Therapy 2/11/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 2/11/2001 Breast Hormonal Therapy 2/11/2006 Femara (letrozole) Dx 2/2014, ILC, Grade 3, 0/3 nodes, ER-/PR-, HER2- Surgery 3/24/2014 Lymph node removal: Left, Right; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/1/2014 AC + T (Taxol) Surgery 11/19/2014 Reconstruction (left); Reconstruction (right) Surgery 1/13/2015 Reconstruction (right): Tissue expander placement Surgery 5/27/2015 Reconstruction (right): Latissimus dorsi flap, Silicone implant Surgery 2/22/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Feb 4, 2019 02:56PM jaycee49 wrote:

Revaree has a subscription price of $40 for 10 suppositories with free shipping. Without the subscription, it is $55 plus $5 shipping. If you read the fine print, you see the subscription discount is only good for the first month. You do continue to get free shipping. So, yeah, it is more expensive than other products like Premeno Duo and Hyalo Gyn. All are still very expensive.

Janet (dx with MS at 41, slows me down some) Dx 4/25/2014, IDC, 3cm, Stage IIB, Grade 2, 1/18 nodes, ER+/PR+, HER2+ Surgery 6/4/2014 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Targeted Therapy 8/4/2014 Herceptin (trastuzumab) Chemotherapy 8/4/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 10/1/2014 Chest wall Hormonal Therapy 2/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 3/25/2016, IDC, Left, Stage IV, metastasized to bone/lungs, Grade 2, 1/18 nodes, ER+/PR+, HER2- (FISH) Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole)
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Feb 4, 2019 08:39PM Mominator wrote:

jaycee49: Thank you for all the information. So if you just ran out of the Premeno Duo, you have been using it. Did you like it? Did it help to reduce dryness and other symptoms? Also, will you be trying the Hyalo Gyn? I would be interested in your opinion on its use. Thank you also for the research into prices. 

anotherNYCGirl: Thank you also. Good to know that Revaree was not uncomfortable for you. So some products burn? Ouch! Which ones? I'd like to avoid anything that burns. 

Mominator, BRCA2+, STK-11 VUS, wife, mom to 3 children of various special needs, musician, volunteer. My Mom dx DCIS age 62, ILC stage IIIA age 79; Mom just passed 2/28/18. My Grandmother died of ovarian cancer age 48. Friend to Lori M, died 5/25/16. Surgery 11/10/2015 Prophylactic mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 1/17/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 6/29/2017 Reconstruction (left): Silicone implant
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Feb 5, 2019 10:52AM jaycee49 wrote:

Mom, I do like Premeno Duo. I used some kind of vaginal moisturizer every night for four months after multiple (multiple multiple) UTI's. I'd use Premeno Duo every third night and Key-E coconut oil suppositories the two nights in between. That is MUCH cheaper and very good. That was at the beginning of 2018. I had a few more UTI's but then no more. Vaginal dryness is way better. Sex with penetration is not possible for me and never will be but we get by other ways. I had vaginal atrophy before cancer dx. Where I live, you have to be careful ordering any of these products in the Summer. They melt in the heat and get all squished out of shape. You can put them in the fridge and they harden up and still work as far as I know. Some of them can be hard to open with old weak fingers. Premeno Duo is the best in that regard. It is actually my favorite in all regards. It has a pH balancing component (thus the duo) which is good because coconut oil alone will cause yeast over time for me. I talked my self into it. I may go to Amazon and buy some, especially now that I know it is cheaper than some others. BTW, the Hyalo Gyn tubes of gel come with 10 applicators. So 10 doses for $25 if you buy three tubes. Not bad.

Janet (dx with MS at 41, slows me down some) Dx 4/25/2014, IDC, 3cm, Stage IIB, Grade 2, 1/18 nodes, ER+/PR+, HER2+ Surgery 6/4/2014 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Targeted Therapy 8/4/2014 Herceptin (trastuzumab) Chemotherapy 8/4/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 10/1/2014 Chest wall Hormonal Therapy 2/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 3/25/2016, IDC, Left, Stage IV, metastasized to bone/lungs, Grade 2, 1/18 nodes, ER+/PR+, HER2- (FISH) Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole)
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Feb 6, 2019 09:38AM - edited Feb 6, 2019 11:21AM by anotherNYCGirl

Mominator, - I have always been very sensitive to internal products, and that included Replens. Even with the Hyalogyn, I am not so comfortable when I first put it in, but that subsides quickly. I also apply coconut oil or Aquaphor (as per my gyn suggestion) to the outer area.

It's amazing how much we took for granted at one time! As I apply my various face creams, hair thickening products, eye drops and warm compresses for dry eye, occasional teeth whitening strips, and routine "internal moisturizers", I miss the days when I didn't need any of those things!

Dx 1998, DCIS, Stage 0 Surgery 3/17/1998 Lumpectomy: Left Dx 6/2000, ILC, Stage IA, 0/3 nodes, ER+/PR+, HER2- Surgery 7/10/2000 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/31/2000 CMF Hormonal Therapy 2/11/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 2/11/2001 Breast Hormonal Therapy 2/11/2006 Femara (letrozole) Dx 2/2014, ILC, Grade 3, 0/3 nodes, ER-/PR-, HER2- Surgery 3/24/2014 Lymph node removal: Left, Right; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 5/1/2014 AC + T (Taxol) Surgery 11/19/2014 Reconstruction (left); Reconstruction (right) Surgery 1/13/2015 Reconstruction (right): Tissue expander placement Surgery 5/27/2015 Reconstruction (right): Latissimus dorsi flap, Silicone implant Surgery 2/22/2016 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Feb 11, 2019 11:34AM Kali44 wrote:

Hi ladies,

I haven't been on here for a while but I do intermittently read updates as I am still, like many of you, trying to figure out how to have a sex life that actually exist and is fulfilling. Of course saying sex life doesn't mean I actually have one. We tried for the second time this past weekend, since my diagnosis and treatment started 3 years, so I don't want to mislead you into thinking that there's really a whole going on Sad This brings me to my question.

I was doing some research and I came across this Dr. who has also experienced vaginal dryness, in her case, not because of cancer. Anyway, she has this product called JULVA which she claims helps with the side effects, on the vaginal area, from cancer treatment and with the normal process of aging and what that means for women with issues regarding sex.


Has anyone tried this before and if so what do you think?

Her name is Dr. Anna Cabeca....any thoughts?

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Feb 11, 2019 12:01PM jaycee49 wrote:

I've read about this product and was intrigued. The problem for me is that it contains DHEA. My MO does not allow any estrogen or DHEA for ER+ cancer like mine. The ingredients look good but it is pretty expensive and the doctor looks slightly shady to me. Since I look at these kinds of products online all the time, I end up seeing ads for them on FB and in news feeds etc. A cottage industry has developed around this type of product and you have to be very cautious when/if buying them. As we know, being a doctor doesn't make you an expert on anything.

Janet (dx with MS at 41, slows me down some) Dx 4/25/2014, IDC, 3cm, Stage IIB, Grade 2, 1/18 nodes, ER+/PR+, HER2+ Surgery 6/4/2014 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Targeted Therapy 8/4/2014 Herceptin (trastuzumab) Chemotherapy 8/4/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 10/1/2014 Chest wall Hormonal Therapy 2/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 3/25/2016, IDC, Left, Stage IV, metastasized to bone/lungs, Grade 2, 1/18 nodes, ER+/PR+, HER2- (FISH) Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole)
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Feb 12, 2019 01:34PM Kali44 wrote:

Hi jaycee49,

Thanks for your reply. I thought DHEA was a concern but the one person who this Dr. had as someone who tried the product and loved it, I thought, she said she too is ER+...argh. Oh well. I was hoping that this may have been a possibility for us ladies.

And so we continue to research products.

Thanks again Smile

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Feb 14, 2019 08:13PM chicopeach57 wrote:

I was ER+ but my MO has prescribed Estrace. He suggested I try the DHEA, it gave me constant weird dreams and nightmares. I tried it twice just to make sure, even used it longer the second time to see if I could adapt, nope.

I cannot believe how much effort it takes to try and enjoy intimacy, really does make me realize what I took for granted.


A strong person is not the one that does't cry. A strong person is one who is quiet and sheds tears for a moment and then picks up her sword and fights again. Ash Sweeney Dx 11/13/2013, IDC, Right, 1cm, Stage IIIA, Grade 3, 4/11 nodes, ER+/PR+, HER2- Surgery 11/22/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 12/13/2013 AC Chemotherapy 2/28/2014 Taxol (paclitaxel) Radiation Therapy 5/19/2014 Breast Hormonal Therapy 5/23/2014 Femara (letrozole) Surgery 12/9/2014 Reconstruction (right)
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Feb 15, 2019 12:46PM Kali44 wrote:

Hi ladies,

me again Happy so I need to order my moisturizer and I found this one and wondered if anyone has tried it.


Femallay Original Personal Wellness Vitamin E Vaginal Moisturizing Suppositories with with Organic Coconut Oil + Botanical Ingredients for Sensitive Women, Box of 14 + Vaginal Applicator (Unscented)

And one other question for you all. Do you always run these products by docs or if it says no hormones do you buy it and try it on your own?

chicopech5 my doc won't rx anything with hormones and or Dhea Sad

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Feb 15, 2019 01:42PM jaycee49 wrote:

Kali, I have used that Femallay product. It is good, as good as other (much cheaper) coconut oil, etc. products. The cheapest is called Key-E suppositories. I don't use anything with an applicator (single use plastic is a no no for me). My finger works fine. I have a big spreadsheet of all the products I've bought and used. I can't post it on BCO because the format of a spreadsheet is ruined by the forum software. If you PM me your email address, I will send it to you. I do not run these kinds of products by my MO except maybe in passing. I do tell my gyn but not to get her permission. She is just interested for her other patients.

Janet (dx with MS at 41, slows me down some) Dx 4/25/2014, IDC, 3cm, Stage IIB, Grade 2, 1/18 nodes, ER+/PR+, HER2+ Surgery 6/4/2014 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Targeted Therapy 8/4/2014 Herceptin (trastuzumab) Chemotherapy 8/4/2014 Carboplatin (Paraplatin), Taxotere (docetaxel) Radiation Therapy 10/1/2014 Chest wall Hormonal Therapy 2/14/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 3/25/2016, IDC, Left, Stage IV, metastasized to bone/lungs, Grade 2, 1/18 nodes, ER+/PR+, HER2- (FISH) Targeted Therapy Ibrance (palbociclib) Hormonal Therapy Femara (letrozole)
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Feb 15, 2019 09:53PM - edited Feb 15, 2019 09:56PM by MERMAID_girl

This Post was deleted by MERMAID_girl.
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Feb 15, 2019 09:56PM MERMAID_girl wrote:

Coachvicky— hello, just had my first Juliet laser internal and external treatment two weeks ago I've been using Aquaphor. Seems to really help. Have you used it?

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Feb 16, 2019 09:21AM coachvicky wrote:

MERMAID...

Thank you! Just looked up Aquaphor. I will ord.er some today

I hope that your treatment went well. I did about 6 weeks between treatments one and two. I did twice the time between two and three and my GYN was able to go significantly higher the second time.

CoachVicky


Dx 6/2016, DCIS/IDC, Both breasts, Stage IIA, Grade 3, ER+/PR+, HER2+ (FISH) Dx 6/7/2016, LCIS/DCIS/IDC, Right, 4cm, Stage IIA, Grade 3, ER+/PR+, HER2+ (FISH) Surgery 7/11/2016 Mastectomy; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 8/21/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 8/22/2016 Herceptin (trastuzumab) Surgery 1/20/2017 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Surgery 2/22/2017 Prophylactic ovary removal Hormonal Therapy 4/4/2017 Arimidex (anastrozole) Surgery 10/19/2017 Surgery Targeted Therapy
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Feb 20, 2019 03:39PM Magari wrote:

Wanted to let people know that switching to a moisturizing body wash instead of regular soap has made a significant difference for me in terms of external dryness.

I have coconut oil for internal moisturizing and find it works fairly well.

My primary issue at this point is reduced desire. Not sure if that is due to the Arimidex or something else. I still find my husband attractive and we're only in our 50s. I *want* to want to, but somehow I just don't very often. Which makes me sad....


DTI reconstruction; Cold capped during chemo to save my hair Dx 9/1/2017, DCIS/IDC, Both breasts, <1cm, Stage IB, Grade 3, 1/3 nodes, ER+/PR+, HER2+ Surgery 10/16/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Targeted Therapy 11/27/2017 Perjeta (pertuzumab) Targeted Therapy 11/27/2017 Herceptin (trastuzumab) Chemotherapy 11/27/2017 Carboplatin (Paraplatin), Taxotere (docetaxel) Hormonal Therapy 6/3/2018 Arimidex (anastrozole)
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Feb 20, 2019 10:27PM thecargirl wrote:

I tried the "O-SHOT" procedure and it really helped! The injection of your own platelet-rich plasma into your lady parts stimulates a quicker sexual response, you also feel more sexual. The platelets stimulate the growth of new cells making you more sensitive, it also helps with frequency issues.

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