Hope that today's title is another attention grabber! I have written a number of times about issues of sexuality and intimacy, but this post is stimulated by an excellent column by Jane Brody in The New York TImes about treating vaginal pain. This problem certainly is not unique to women who have been treated for cancer, but it is an issue for many who have. The simple explanation is that menopause, especially the sudden chemically or surgically induced menopause that many of us experience, results in thinner vaginal walls and less natural lubrication. Lubrication can be introduced, of course (and again: a plug for the two products that work very well and are non-embarrassing to buy: canola oil and Albolene, a facial cleanser), but thickening up the vaginal walls is tougher.
Estrogen works best, and there are prescription products (Estring, a vaginal ring or estroen tablets or estrogen creams) that are usually very helpful BUT there are concerns about intoducing estrogen into our bodies, especially if we have had estrogen positive breast cancers. This becomes a topic to discuss with your doctor because quality of life surely matters. If the other suggested treatments don't help, and if sex is impossible (and sometimes the situation is so dire that just sitting is uncomfortable), it seems reasonable to consider one of these solutions.
Here are some things to try first:
1. Position matters. The missionary position is the worst for women who experience pain with intercourse. Pick another where you are on top or on the side or somehow have control of the rhythm and depth.
2. Regular daily use of almond oil or Vit E (no need to squeeze out of the capsules as they will naturally dissolve) applied inside your vagina
3. Physical therapy (yes, there are physical therapists who specialize in this) and/or exercises that strengthen the pelvic floor.
Most importantly, don't give up! Intimacy and closeness are hugely important in loving relationships, and we have surely learned the value of love.
Here is the beginning of Ms Brody's article and then a link to read more:
Persistence Is Key to Treating Vaginal Pain
By JANE E. BRODY
Millions of women experience vaginal discomfort, and sometimes crippling pain, for a variety of reasons, most often a loss of estrogen. The resulting vaginal dryness and atrophy can make sexual intercourse, a pelvic exam, urinating, or even sitting, walking or cycling a painful nightmare.
In addition to women near or past menopause, those affected include women who have recently given birth or are breast-feeding, women treated with estrogen-suppressing drugs for breast cancer or given chemotherapy or pelvic radiation for other cancers, and women whose ovaries were surgically removed.
With women now living more than a third of their lives past menopause and more and more surviving cancer, sexual problems linked to estrogen decline are increasingly common.
Yet, only about one-quarter of women with vaginal pain ever report the problem to a medical professional. And those who do speak up are often told - incorrectly - that nothing can be done and that they must learn to live with the pain.