Sex after breast cancer

Dr. Barb DePree MDby Dr. Barb DePree, M.D.

Recovery from breast cancer is a long and challenging road that frequently involves making peace with lots of change—different bodily sensations, altered abilities, different goals and perspectives. As with any change, we need some time to adjust to our “new normal.” But just like during menopause, time is not our friend. New habits and treatments are best begun right away; after breast cancer, we have fewer treatment options when sexual health symptoms appear. That makes prevention more critical.

Most basic: vaginal moisturizer. This is for regular, daily use, not just for sex. It conditions the vagina and keeps the tissue healthy and moist. Look for moisturizers natural ingredients, without parabens. MiddlesexMD has several options especially recommended: PrevaLeaf Oasis Natural Daily Vaginal Moisturizer, and Emerita Feminine Personal Moisturizer. Lubrigyn offers both a cleansing lotion and a moisturizer/lubricant that promote the retention of moisture.

Use a lubricant lavishly in your vagina for extra lubrication during sex. Again, check ingredients for the most natural; stay away from products with parabens, glycerin, and petrochemicals. Chiavare Oil is all-natural and nourishing; Aloe Cadabra is 95-percent organic aloe; Almost Naked Personal Lubricant is 95-percent organic; Restore Moisturizing Vaginal Lubricant has lasting moisturizing benefits.

In February 2016, the American Congress of Obstetricians and Gynecologists (ACOG) published a Committee Opinion on the use of vaginal estrogen for managing urogenital symptoms, which can include lower urinary tract infections and sexual discomfort. Their findings reinforce non-hormonal options, like the moisturizers mentioned above and other over-the-counter products available from MiddlesexMD, as the first resort for breast cancer patients.

Then, the Committee Opinion goes on, "data do not show an increased risk of cancer recurrence among women... who use vaginal estrogen to relieve urogenital symptoms." This is good news for those women for whom non-hormonal options have not been or continued to be successful because the localized use of hormones is not off the table. (To read the ACOG Opinion, follow this link; NPR reporter Dana Farrington reported on the announcement in the story found here.)

Now for the rest of that toolkit. These are items that can be very helpful to breast cancer survivorsand to lots of other women, too.

  • Pillows. Lots of pillows for soft support where you need it. If a position feels ouchy, try cushioning the area with a pillow.
  • Erotic movies and other scene-setting paraphernaliacandles, incense, music.
  • Sexy attire. If you need to start out—or stay—clothed for a while, get sexy lingerie that covers the strategic parts.
  • Read the information about vaginal comfort and genital sensation on this website and the very helpful blog posts about sex after cancer from Dr. Mary Jo Rapini.

Below are a few good starting places in the ongoing conversation about sex after breast cancer.