SEXUAL CHANGES

Menopause, also called “the change of life”, is the body’s response to the lower amounts of female hormones.  Drugs used to treat breast cancer can cause the change of life to start early (some women have a brief time without menstruation, and others stop altogether).  Symptoms of the change may include vaginal dryness, pain during sex and changes in the ability to have children.  These problems can be more severe than changes that occur naturally without drugs.  If you are having symptoms of sexual changes due to aging or as a result of treatment here are a few tips that may help you:

Vaginal Dryness

  • Use water-based lubricants such as K-Y Jelly (Johnson & Johnson), Astroglide (Astro-Lube, Inc.), Pre-Seed® (much like your natural lubrication) or Replens (Parke-Davis).
  • Do not use oil-based lubricants such as Vaseline or baby oil because they cause irritation to the vagina.
  • Check with your doctor about using a non-estrogen based cream or gel. Many doctors wait for you to ask about these issues, so don’t be afraid to discuss this with them. Some oncologists feel that manually applying a small amount of estrogen cream is safe. Your medical oncologist should be the physician to approve and prescribe vaginal estrogen creams. Estring® was shown to have virtually no impact on blood estrogen levels, and may be a good option for women. Additionally, women taking Tamoxifen are better able to use these medications, as the Tamoxifen blocks all estrogen in the body.
  • Take things slowly. If you take a little more time, your body has time to stretch and work on its own.

Pain during Sex

  • Take the time to try different positions.  After surgery, some women do not prefer that their spouse or partner’s weight rest on them.
  • Think about making love in a side-by-side position.  Try other ways that may not be painful.
  • Reduce weight on your surgical site to decrease pain.  Support yourself with pillows for comfort.
  • Take pain medicine before having sex if needed.
  • If your pain is related to muscle spasms, consult your doctor for any therapies they might suggest.

Fatigue and Sex

  • Be flexible about the time of day you make love. Choose a time you’re less tired and have more energy.
  • Try less demanding positions.  Discuss with your spouse or partner that making love need not start with a long session.

Pregnancy/Fertility

  • If you have not gone through the change of life and have regular periods, or are on hormonal therapy, you will need to use some form of barrier contraception to avoid becoming pregnant.  Even if you are not having regular periods, you may still ovulate and could become pregnant. Use barrier protection to avoid becoming pregnant after treatment with chemotherapy for at least two years or during the entire time that you are on hormonal therapy.

When Do You Need to Seek Help?

You need to be able to talk openly with your spouse or partner.  If you keep having trouble in communicating, consider seeing a professional counselor or support  group that discusses these issues. These issues are very common among breast cancer survivors, so don’t feel like you are alone on this journey.

Useful websites:
American Cancer Society: Sexuality
Breastcancer.org: Changes in your sex life
National Cancer Institute: Body changes and intimacy
WebMD article

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