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Vaginal Dryness or Atrophy

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Vaginal dryness is an extremely common side effect of several treatments for metastatic breast cancer, of sudden-onset menopause caused by treatment, and from natural menopause. Vaginal dryness happens when estrogen levels drop, causing the walls of the vagina to become thinner, less flexible, and to produce less lubrication. Chemotherapy, for example, can bring on menopausal symptoms, including vaginal dryness. Hormonal therapy can cause the vagina to produce less lubrication. In some women, risk-reducing hysterectomy including the removal of the ovaries can also cause menopause, leading to vaginal dryness.

Regardless of the cause, vaginal dryness can make sex uncomfortable or even downright painful. When this happens, a variety of products and tips can help:

  • Try a vaginal lubricant. If your body is not producing enough moisture on its own, using a vaginal lubricant may help make intercourse or penetration more comfortable. Apply and reapply it as needed in and around your vagina to relieve friction and ease dryness and pain. Most lubricants are water-, silicone-, or oil-based and are found over the counter and at many online stores. They can be washed off with soap and warm water. A 2016 study found that women diagnosed with breast cancer preferred silicone over water-based lubricants and that total sexual discomfort was lower with silicone-based lubricants than with water-based lubricants. If you feel self-conscious purchasing a lubricant at the drugstore or in a shop, you can always order online.
    • Lubricants to avoid. The simpler the ingredients list, the better. If you can pronounce it and know what it is, the ingredient is likely okay to use. Stay away from lubricants that are perfumed, petroleum-based (like Vaseline), or oil-based (these may increase the risk of vaginal infection, tend to have an unpleasant odor, and can damage latex condoms). Since little is known about their safety, also avoid lubricants that give sensations of warmth or tingling. It’s also a good idea to avoid parabens. They can penetrate the skin and act like a very weak estrogen in the body. In addition, stay away from lubricants with propylene glycol, a form of alcohol that could be irritating, and glycerin, which can promote yeast infections.
    • Reputable brands include Good Clean Love and Slippery Stuff Paraben Free, which are water-based; Uberlube, which is silicone-based; and Sliquid, which comes in both water-based and silicone-based formulations. Read the labels (or research what’s in them) and try to avoid lots of chemical ingredients. Several women in the community also recommend “Scream Cream,” a vasodilator (it relaxes the blood vessels, allowing more blood flow to the clitoris). Your pharmacist must create this cream by hand, and you need a prescription from your physician.
    • Natural oils such as mineral oil and coconut oil also work, but it’s important to know that they can break down the material in condoms.
    • Use products intended for vaginal use. Hand creams and body lotions are not good choices since they can contain irritating ingredients.
    • Ask your healthcare provider about prescription lubricants.
  • Foreplay can also help. Foreplay is important to help all women get to a state of arousal. A slow, methodical foreplay session can sometimes make a difference in helping you to become more excited and naturally lubricated.
  • Change your position. Certain positions might feel better than others. Experiment with different positions and see what feels most comfortable for you.

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