Dealing with Sex After Cancer Treatment When you first think about sex after cancer treatment, you may worry about having painful intercourse or not being able to have an orgasm. Your first sexual experience after treatment may not be what you hoped it would be. But just as you grew to appreciate sexual pleasure during your first sexual encounters, you can learn to enjoy sex again after cancer treatment. People often realize that her sex life is less than perfect compared to what it was before treatment and that something needs to change. Try some kind of change to enjoy sex in a new way. After cancer treatment, some changes may occur in your sexually sensitive areas, and areas that used to be pleasurable for sexual stimulation may now be painful to stimulate. You may also find that your old favorite spots for sexual pleasure have changed. If you’ve had surgery on your vagina and vaginal opening, you may need to gradually get used to new sexual feelings during intercourse. Here we’ll review some of the most common changes and offer some ways to deal with them. Vaginal dryness Cancer treatments often result in a decrease in vaginal secretions during sexual arousal, and it is often necessary to make intercourse comfortable by using some lubricant. If you use a lubricant, you should choose one that is water-based and free of scents, pigments, and spermicidal drugs. This is because these ingredients may irritate sensitive genital tissues. Some containing lubricants contain herbal ingredients, which may also cause irritation or allergic reactions in some people. So always read the product instructions carefully and consult a doctor, nurse or pharmacist before use. Vitamin E cream can also be used as a vaginal lubricant. It can be squeezed directly into the vagina or squeezed onto a finger then rubbed into the vagina. Some women improve vaginal dryness by using topical vaginal hormones. These hormones are more effective when applied topically to the vagina and absorbed into the genital tissues than when taken by mouth. These hormones can be made into creams, ointments, rings, or tablets. Most are put directly into the vagina and some can be in the vaginal opening. Topical vaginal hormones as medications require a doctor’s prescription. Petrochemical gels, skin lotions and other oil-based lubricants are not ideal vaginal lubricants. For some women, these ingredients may induce fungal infections. Latex condoms may also be damaged by petrochemicals or lotions if used. Before intercourse, you can rub some lubricant around and inside the vaginal opening. Then apply some to the surface of your sex partner’s penis, fingers or other inserts. These help to lubricate the inside of the vagina. Many couples also use these as part of sexual foreplay. If intercourse takes longer than a few minutes, you may also need to stop for a short while and use some more lubricant. Even if you regularly use vaginal moisturizers, you can use a vaginal lubricant if needed. Early menopause If you are experiencing early menopause due to cancer treatment, you may be bothered by frequent hot flashes, especially at night. Some women experience a decrease in libido that is due more to increased stress in the mind and poor sleep than to a lack of female hormones. Hormone replacement therapy can relieve vaginal dryness and hot flashes, but estrogen promotes the development of breast and uterine cancer, and possibly ovarian cancer, as well as causing other health problems, so doctors are not as willing to use these medications at this time as they have been in the past. Women with vaginal dryness may use creams, ointments, or pills with small doses of estrogen, or birth control rings placed inside the vagina. Pills and rings with small doses of estrogen slowly release estrogen into the vagina and the tissues around it, but very little of it gets into the bloodstream to affect the rest of the body. If you have any questions or concerns about hormone replacement therapy, talk to your doctor about the pros and cons of this treatment for you. If your doctor feels that hormone therapy is the best approach for you, using the lowest dose for the shortest period of time is ideal. It is important for patients receiving hormone therapy to have regular annual checkups. If your doctor does not recommend hormone replacement therapy, menopausal symptoms can be treated in other ways, such as taking medications that control the lack of response to estrogen. The medications that are often used for this treatment are called serotonin reuptake inhibitors. Examples include vanlafaxine, fluoxetine, and paroxetine. Some women patients with less severe symptoms can get relief in other ways, such as participating in exercise and some changes in the environment to relax. You can consult your doctor and other specialists to choose a method that works for you. Coping with the absence of a body part Some female patients are missing a part of their body due to cancer surgery, especially the breasts and external genital parts, which can lead to a lack of sexual pleasure that they would have gotten from sexual contact. If this is the case for you, touch your whole body yourself or ask your lover to do so, and you will find other parts that can replace the original erogenous zones. Many women are reluctant to learn about and touch the private parts of their bodies. However, after cancer surgery, a deeper understanding of your external genitalia is very important to regain sexual function for sexual pleasure. Spend some time looking at and touching your genitals to learn more about them. Have you ever looked at your genitals in a mirror? Most women haven’t, or at least don’t have a clear idea of where the various parts of the genitals are located. Using a hand-held mirror, look at your external genitals to see the labia majora, labia minora, clitoris, urethra, vaginal opening and anus. Gently touch each part with your fingers, touching the anus last to avoid contaminating the urethra and vagina. Is that area the most sensitive part? If you’re reluctant to look at your external genitalia or feel it’s unsightly, try looking at it again at another time! Will your negative feelings still make that strong? Some artists often compare the female genitalia to flowers or sea shells. Are you able to find it beautiful? Is it possible that you have had your external genitalia altered as a result of surgery? If so, this is a way for you to get used to the changes and to find out if certain areas are still painful or sensitive by touching them.