Sexuality for the Woman With Cancer

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Vaginal dryness


Cancer treatments often reduce the amount of lubricant produced in your vagina when you are excited. You may need extra lubrication to make intercourse comfortable. If you use a vaginal lubricant, choose a water-based gel that has no perfumes, coloring, spermicide, or flavors added, as these chemicals can irritate your delicate genital tissues. Lubricants can usually be found near the birth control or feminine hygiene products in drug stores or grocery stores. Common brands include K-Y Jelly® and Astroglide®. Be aware that some of the newer lubricant products include herbal extracts (such as aloe or lavender), which may cause irritation or allergic reactions in some people. Also, warming gels can cause burning in some people. Be sure to read the labels, and talk with a nurse, doctor, or pharmacist if you have questions.

Petroleum jelly (Vaseline®), skin lotions, and other oil-based lubricants are not good choices for vaginal lubrication. In some women, they may raise the risk of yeast infection. And if latex condoms are used, they can be damaged by petroleum products and lotions. Also, watch out for condoms or gels that contain nonoxynol-9 (N-9). N-9 is a birth control agent that kills sperm, but it can irritate the vagina, especially if the tissues are already dry or fragile.

Before intercourse, put some lubricant around and inside the entrance of your vagina. Then spread some of it on your partner’s penis, fingers, or other insert. This helps get the lubricant inside your vagina. Many couples treat this as a part of foreplay. If vaginal penetration lasts more than a few minutes, you may need to stop briefly and use more lubricant. Even if you use vaginal moisturizers every few days, it’s best to use gel lubricant before and during sex.

Vaginal moisturizers

As women age, the vagina can naturally lose moisture and elasticity (the ability to stretch or move comfortably). Cancer treatments and risk-reducing surgery (such as removing the ovaries) can hasten these changes. Vaginal moisturizers are non-hormonal products intended to be used several times a week to improve overall vaginal health and comfort. You can buy them without a prescription. Vaginal health is not only important for sexual activity, but also for comfortable gynecologic exams.

Vaginal moisturizers are designed to help keep your vagina moist and at a more normal acid balance (pH) for up to 2 to 3 days. Vaginal moisturizers are applied at bedtime for the best absorption. It should be noted that it’s not uncommon for women who’ve had cancer to need to use moisturizers up to 3 to 5 times per week. Vaginal moisturizers are different than lubricants – they last longer and are not usually used for sexual activity.

Replens® and K-Y Liquibeads® are examples of vaginal moisturizers. Lubrin® and Astroglide Silken Secret® are other moisturizers that are marketed as longer lasting than typical lubricants. Vitamin E gel caps can also be used as a vaginal moisturizer. Use a clean needle to make a small hole in the gel cap and either put the entire capsule into your vagina or squeeze some of the gel onto your fingers and put them into your vagina. Be aware that vitamin E may stain undergarments.

Vaginal estrogens

Topical or systemic estrogen therapy is a treatment option for vaginal atrophy (when the vaginal walls get thinner and less stretchy) for most post-menopausal women. But hormone treatments can be a complex issue for many women and health care providers in the cancer setting.

Many women do well with local vaginal hormones to help vaginal dryness. These hormones are applied to and absorbed into the genital area, rather than taken by mouth. They come in gel, cream, ring, and tablet forms. Most are put into the vagina, although some creams can be applied to the vulva. Local vaginal hormones must be prescribed by a doctor and should first be discussed with your oncologist.

Last Medical Review: 08/29/2013
Last Revised: 08/29/2013