April 26, 2018

Ask Barbara

I’m receiving lots of questions related to breast cancer treatments and sexuality, so I thought that I’d begin an “Ask Barbara” portion of the blog so that everyone can benefit from these questions and share your experiences and questions as well. Here’s the first:

“I am so focused on treatment I can’t think of much else!  I am having difficulty getting interested in sex but also when my husband and I attempt it, I lack the necessary vaginal moisture.  KY Silk E helps.  I also am experiencing some pain–has my vagina shrunk?  My breasts are gone–I definitely feel self conscious about my flat chest.  I have no hair, so I look like an old, sick person.  Thinning pubic hair makes me look like a 13 year old girl.  Honestly, I’m not sure I can get past all this.  Do I need to avoid sex and hope the passage of time will help these problems recede?  … am I better off just putting sex on hold for now?  Attempts at sex end up disappointing and sad.”

My heart goes out to you and that wondering if you’ll be able to get past all of this. In the midst of treatment things can be gnarly and surprisingly challenging, and the sadness and despair can make feeling desire, desirable and sexy seem like distant memories. Be kind, gentle and patient with yourself. I hope you’re getting the emotional and psychological support you need to help you navigate this.

These are important questions and concerns, and really speak to many of the facets of our intimacy, femininity and sexuality. First, there’s no need to put sex on hold during treatment. Even with the fatigue, lack of interest and lack of natural lubrication, experiencing intimacy with your partner is important and also helps with the pain and discomfort. Continuing to be sexual keeps the tissue more supple and flexible. And there are things you can do to help with these challenges. Some things to know and tips follow.

Your vaginal tissue has changed as a result of chemotherapy. These drugs are designed to reduce or eliminate estrogen production and this causes menopause. Vaginal tissue becomes friable, which means that it is extremely thin and delicate and tears easily. It also reduces your natural lubrication, as you know. Friable tissue and lack of lubrication can make penetration very painful. Here are some things to remember:

  • Go slow and be very gentle. Ask your partner to follow your lead about when you feel ready for penetration and how far to penetrate and thrust, and when to stop.
  • Use lots and lots of lube. More about lubricants below.
  • When applying lubricants, apply them to your partner as well as to yourself.
  • Don’t have any expectations ~ experiment with not having an agenda for deep penetration or orgasm. Sometimes “performance anxiety” causes pain because we try too hard.
  • Experiment with some gentle vulvar and vaginal touch and massage with lubricant before attempting penetration. Use this to “warm up” and begin to bring blood flow to the tissues, which will help with elasticity and flexibility.
  • Reduced estrogen also reduces libido, but you can still respond to your partner’s gentle invitations and initiation of sex play.
  • Many of these symptoms will lessen and change after you complete chemotherapy ~ your hair will grow back, for example, and you will regain your energy over time.

Regarding lubricants, there are lots of different lubricants and choosing the right one for you is important. KY Silk-E is formulated as a vaginal moisturizing lubricant. Moisturizing lubricants are great to help with vaginal and vulvar dryness. Personally I’m not a big fan of Silk-E. It’s not slippery enough for me and I haven’t found it helps with moisturizing. I like Liquid Silk and Sliquid Organics Silk. They have different pH’s and ingredients. Sometimes the Liquid Silk burns a bit because it is slightly acidic. When that happens, I use Sliquid. It’s also helpful to use silicone-based lubricants to help with vaginal dryness. These lubricants remain on the surface and provide a bit of a “cushion” and can help ease the discomfort of penetration. I like one called Pink.

I’m working on an article about selection personal lubricants, which will soon be on the website. In the meantime, there’s a wonderful website and online store that sells many lubricants and other sexual products: http://www.a-womans-touch.com/store.php. They have a section for women living with cancer that includes some excellent resources. They will also send samples of different products.

You and your sweetie might also consider attending one of our retreats for couples. These are weekends with other couples on this journey, so you can talk with them, as well as get lots of valuable tools and guidance from us. There’s time to practice what we teach in private times, then time with the group to share experiences, get immediate coaching for making things even better, and to enhance your love, intimacy, communication and sexuality. You can find more information in the services section of the website by clicking here. 

There’s lots more to say about all of this, and this is a beginning which should help. I welcome your comments and further questions. Feel free to post here or to send a private email to me at Barbara@sexyaftercancer.com.

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