Female Sexual Dysfunction
Survivors sometimes experience sexual dysfunction after cancer treatment. Knowing what some of the causes are and being able to describe your symptoms to your health care team can help you manage sexual dysfunction.
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Female Sexual Dysfunction: Detailed Information
This information is meant to be a general introduction to this topic. The purpose is to provide a starting point for you to become more informed about important matters that may be affecting your life as a survivor and to provide ideas about steps you can take to learn more. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Suggestions and Additional Resources sections for questions to ask and for more resources.
Cancer and treatment can affect survivors in different ways. One area of life that might change is the ability to have or enjoy sex. These types of changes in women following cancer or treatment are sometimes referred to as female sexual dysfunction. The cause may be physical or emotional.
If this happens, there are a variety of ways to treat and manage this condition. Be sure to discuss any symptoms or concerns with your health care team as early as possible. Some women may feel uncomfortable discussing sexual concerns with a doctor or other members of the health care team. However, they can answer questions, refer you to a specialist if needed, and help you find solutions.
What are some indicators that may cause concern?
The following may be indicators that it is time to talk with your doctor about concerns related to sex after cancer treatment:
- Loss of desire for sex
- Negative thoughts and feelings during sex
- Difficulty reaching climax
- Vaginal dryness and tightness
- Pain during sex or when your genital area is touched
These types of symptoms are not generally considered to be medical emergencies. For this reason, you may wonder if you should bring up the subject to a member of your health care team. Keep in mind that all of your physical and emotional concerns are important. This is especially true if you are experiencing pain during sex or feeling that your intimate relationship has become less enjoyable.
Prepare in advance to talk with your doctor. Write down any questions and concerns you have about your sexual health. You may need to request extra time for your appointment to allow enough time for a discussion. If your doctor cannot help you, ask for a referral to another health care professional who specializes in this area.
Will all female cancer survivors experience sexual problems?
Not all survivors will experience sexual problems. In some cases, a woman may choose to wait a while after treatment before having sex. Another woman may be in a situation where she is ready to resume sexual relations right away. In any case, there may be things that can help you prepare emotionally as well as make the sexual experience more physically comfortable.
If a sexual concern is likely to occur, it may be during and after cancer treatment. Be certain to discuss any problems and symptoms with your doctor—especially if you begin to notice any changes in your ability to have or enjoy sex. Some problems, such as those caused by radiation to the pelvis, may develop months or even years after cancer treatment is done.
What causes sexual functioning concerns after cancer?
There are many different causes of sexual functioning concerns in female cancer survivors. Some are physical causes. Others may be due to changes in how you feel about yourself, your body, or other aspects of your life after cancer.
Certain types of cancer, such as those that affect sexual organs, can put survivors at risk for problems. Approximately half of survivors of breast cancer and other cancers that affect the pelvic area (such as the cervix, ovaries, uterus, bladder, colon or vagina) develop long-term sexual problems. Yet, most problems are actually caused by treatment and not the cancer itself.
Some ways treatment can affect sexual functioning include:
- Chemotherapy can damage the ovaries, causing hormonal changes and temporary or permanent menopause in younger women.
- Radiation can affect the vagina, cervix, or uterus.
- Surgery or radiation therapy can affect cancers in the pelvic area (bladder, colorectal, cervical, ovarian, uterine, vaginal, or vulvar cancer).
- Side effects of medicines used to treat pain, nausea, depression, or anxiety can affect sexual functioning.
If possible, talk with your health care team about the risks for problems with sexual functioning before you begin cancer treatment. There may be things that can be done to minimize risks. If you have already undergone treatment, talk with your doctor about finding ways to treat symptoms or concerns now.
Certain emotions can also contribute to intimacy challenges such as:
- Sad or depressed feelings
- Concerns about being less attractive
- Stress in the relationship with your partner
- Difficulty with self-esteem because of physical changes
If physical changes affect how a woman feels about herself or her body, this can also contribute to sexual problems. For example, it may be more challenging for someone who was uncomfortable with sexuality or had tension in a relationship before cancer. If you have these types of concerns, ask your doctor for a referral to a licensed counselor who has experience working with cancer survivors.
Are there successful treatments for women with sexual concerns?
There are a number of treatment options that can help women with sexual functioning concerns. It is important to discuss problems and concerns with your doctor as early as possible.
Your health care team can help you learn more about how to treat concerns and improve your ability to enjoy sex again. There are many ways to enhance and share pleasure and closeness with your partner. Even survivors who no longer have sex are able to find ways to continue to enjoy deep intimacy with their partners.
Of course, the most important factor in choosing a cancer treatment is its ability to control cancer. However, your sexual health is also important. If you are worried about sexual dysfunction after cancer treatment, talk with your health care team soon as you can about the different therapies that may be available to help you.
This document was produced in collaboration with:
Leslie R. Schover, Ph.D.
Professor of Behavioral Science, UT M. D. Anderson Cancer Center
Works Cited
American Cancer Society. “Sexuality and Cancer: For the Woman with Cancer and Her Partner.” Atlanta: American Cancer Society, 2001 (99-rev. 07/01-50M-no. 4657-HCP).
Andersen, Barbara L. “Surviving cancer: The Importance of Sexual Self-Concept.” Medical and Pediatric Oncology 33 (1999): 15-23.
Ganz, Patricia, Julia A. Rowland, Katherine Desmond, et al. “Life after breast cancer: Understanding women’s health-related quality of life and sexual functioning.” Journal of Clinical Oncology 16 (1998): 501-14.
Grumann, Mareile, Robert Robertson, Neville F. Hacker, and Greta Sommer. “Sexual Functioning in Patients following Radical Hysterectomy for Stage IB Cancer of the Cervix.” International Journal of Gynecologic Cancer 11 (2001): 372-80.
Jensen Pernille T., Mogens Groenvold, Marianne C. Klee, et al. “Longitudinal Study of Sexual Function and Vaginal Changes after Radiotherapy for Cervical Cancer.” International Journal of Radiation Oncology, Biology, and Physics 56 (2003): 937-49.
National Ovarian Cancer Coalition. Ovarian Cancer: Sexuality and Intimacy. Boca Raton, FL: 2003.
Schover, Leslie. Sexuality and Fertility after Cancer. New York: John Wiley & Sons, 1997.
Female Sexual Dysfunction: Suggestions
The suggestions that follow are based on the information presented in the Detailed Information document. They are meant to help you take what you learn and apply the information to your own needs. This information is not intended nor should it be interpreted as providing professional medical, legal and financial advice. You should consult a trained professional for more information. Please read the Additional Resources section for links to more resources.
Sexual Functioning Concerns
|
How to Find Help
|
|
Loss of desire for sex after cancer
|
- Ask a member of your health care team to check your medications for possible side effects.
- Get medical treatment for pain that will not go away or fatigue that may be affecting your energy and desire for sex.
- If you are in menopause, see a gynecologist or an endocrinologist for a blood test to find out if your testosterone is low. Women need some testosterone for good sexual function. However, if you had breast cancer, using replacement testosterone may not be safe for you. Discuss other options with your health care team.
- If there are no physical causes, see a licensed counselor to find out if problems could be related to feelings of depression, anxiety or low self-esteem.
|
|
Difficulty feeling pleasure during sex
|
- Loss of interest in sex may be related to how you feel about yourself.
- Ask for a referral to a therapist who specializes in treating cancer survivors.
|
|
Vaginal dryness and tightness, making sexual activity uncomfortable or painful
|
- Talk with a gynecologist who has expertise in menopause and problems with pain during intercourse.
- Ask your gynecologist, for advice on muscle relaxation, local forms of estrogen, or over-the-counter lubricants.
|
|
Difficulty reaching orgasm
|
- Ask your health care team to check your medications. Antidepressants or anti-anxiety medicines may make it more difficult for you to have an orgasm.
- Give yourself time. Try not to pressure yourself to have an orgasm. Sometimes this makes it hard for you to relax.
- The nerves that help a woman feel pleasure around the clitoris and in the vagina are rarely damaged by cancer treatment. This means the cancer or its treatment may not physically prevent you from having an orgasm.
|
Talk with your doctor about treatment options for sexual concerns. The following table cites common methods that may be recommended, as well as some pros and cons for using them:
|
Treatment options for some types of sexual dysfunction
|
Pros
|
Cons
|
|
Pills
(PDE-5 inhibitors)
|
- Increases vaginal lubrication without using estrogen hormones.
|
- Studies of PDE-5 inhibitors in women do not show a lot of change in female sexual functioning.
|
|
Water-based lubricants
|
- Water-based lubricants last longer and work better than old-style gels.
- Can be purchased at most drugstores or over the Internet.
|
- The lubrication may wear off and need to be re-applied during intercourse.
- May not be effective enough to avoid pain if there is severe vaginal dryness.
|
|
Vaginal moisturizers (such as Replens)
|
- This gel keeps the vaginal lining moist all the time.
- Needs to be used regularly at bedtime for up to two months to reach its full effect.
- May replace the need for water-based lubricants.
|
- Can be costly and is not covered by insurance.
- May be somewhat messy.
|
|
Vaginal estrogen replacement (such as Estring, Vagifem)
|
- Some women prefer these products to vaginal estrogen cream.
- The Estring releases a small dose of hormone over three months.
- The Vagifem suppository is used a couple of times a week.
- Both Estring and Vagifem produce a low dose of estrogen. This is considered to be helpful treating vaginal dryness with very little hormone released into the bloodstream. Generally thought to be safer than pills, patches, or creams.
|
- Some oncologists still worry about breast cancer survivors using these products.
|
|
Find comfortable positions for intercourse
|
- Certain positions may help avoid pain during sex.
|
- Requires good communication between partners.
|
|
Learn to relax muscles around the vaginal entrance
|
- Learn methods of relaxation to avoid pain during intercourse.
|
- Can help minimize pain, but may not relieve pain if scarring exists.
|
|
Herbs and lotions
|
- Lotions may act as lubricants.
|
- No studies have shown lotions to help with sexual dysfunction.
- Some lotions may be irritating to the skin or tissues.
- Herbal remedies may interfere with other medicines or may have unknown dangers.
|
|
Clitoral pump (such as Eros)
|
- A small pump used to draw blood into the clitoris to increase sexual arousal.
|
- No scientific evidence that it works.
- Costly and not covered by insurance.
- Gives sensation similar to a vibrator.
|
Works Cited
American Cancer Society. “Sexuality and Cancer: For the Woman with Cancer and Her Partner.” Atlanta: American Cancer Society, 2001 (99-rev. 07/01-50M-no. 4657-HCP).
Andersen, Barbara L. “Surviving cancer: The Importance of Sexual Self-Concept.” Medical and Pediatric Oncology 33 (1999): 15-23.
Ganz, Patricia, Julia A. Rowland, Katherine Desmond, et al. “Life after breast cancer: Understanding women’s health-related quality of life and sexual functioning.” Journal of Clinical Oncology 16 (1998): 501-14.
Grumann, Mareile, Robert Robertson, Neville F. Hacker, and Greta Sommer. “Sexual Functioning in Patients following Radical Hysterectomy for Stage IB Cancer of the Cervix.” International Journal of Gynecologic Cancer 11 (2001): 372-80.
Jensen Pernille T., Mogens Groenvold, Marianne C. Klee, et al. “Longitudinal Study of Sexual Function and Vaginal Changes after Radiotherapy for Cervical Cancer.” International Journal of Radiation Oncology, Biology, and Physics 56 (2003): 937-49.
National Ovarian Cancer Coalition. Ovarian Cancer: Sexuality and Intimacy. Boca Raton, FL: 2003.
Schover, Leslie. Sexuality and Fertility after Cancer. New York: John Wiley & Sons, 1997.
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Female Sexual Dysfunction: Additional Resources
The previous sections of this document provide detailed information, suggestions, and questions to ask related to this topic. This section offers a listing of additional resources that are known to provide support and quality services that may be helpful to survivors during the cancer journey.
LIVESTRONG Care Plan
www.livestrongcareplan.org
This free online tool was created to help you develop a personalized plan for post-treatment care. It can help you work with your oncologist and primary health care provider to address medical, emotional and social challenges that may arise after cancer treatment is completed. By answering some questions related to your cancer treatment, you will receive information about your follow-up care. This information includes symptoms to watch for in the future and steps you can take to stay healthy.
LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare
| Email: |
Send email through the LIVESTRONG website. |
| Phone: |
1-866-673-7205
1-866-927-7205 (Spanish) |
|
Intake Coordinator is available for calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (Central Time). Voicemail is available after hours. |
LIVESTRONG SurvivorCare offers assistance to anyone affected by cancer, including the person diagnosed, loved ones, caregivers and friends. The program provides information about treatment options and matching to clinical trials or treatments in development. Counseling services and assistance with financial, employment and insurance issues are also available. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations including CancerCare, Patient Advocate Foundation and EmergingMed.
American Cancer Society (ACS)
www.cancer.org
| Email: |
Submit questions in English or Spanish from the “Contact Us” page. |
| Phone: |
1-800-227-2345
TTY for deaf or hard of hearing callers: 1-866-228-4327 |
The American Cancer Society (ACS) offers information about many of the challenges of cancer and survivorship. You can search for information by cancer type or by topic. ACS provides a list of support groups in your area. You can join online groups and message boards. Some information on the website is available in Spanish, Chinese, Korean and Vietnamese. ACS specialists can answer questions 24 hours a day by phone or email.
U.S. Institutes of Health - National Cancer Institute (NCI)
www.cancer.gov
| Online: |
Online assistance is available in English or Spanish through the LiveHelp instant messaging system. This service is available Monday-Friday, 9:00 a.m. to 11:00 p.m. (EST) |
| Email: |
Send an email through the “Need Help?” section of the website |
| Phone: |
1-800-422-6237
TTY for deaf and hard of hearing callers: 1-800-332-8615
Information specialists answer calls Monday-Friday, 9:00 a.m. to 4:30 p.m. local time. |
The National Cancer Institute’s website provides accurate information about the challenges cancer can bring. You can search for information by cancer type or topic. You can find information about treatment, financial and insurance matters. You can also learn how treatments in development work and search for a clinical trial in your area. This site also has a good dictionary of cancer terms, drug information and other publications. Cancer information specialists can answer your questions about cancer and help you with quitting smoking. They can also help you with using this Web site and can tell you about NCI's printed and electronic materials. The knowledgeable and caring specialists have access to comprehensive, accurate information on a range of cancer topics, including the most recent advances in cancer treatment. The service is confidential, and information specialists spend as much time as needed for thorough and personalized responses.
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Female Sexual Dysfunction: Detailed Information
Cancer and its treatment can affect many different aspects of your life. One area of your life that might have changed is your ability to have or enjoy sex. These changes are sometimes referred to as sexual dysfunction caused by cancer or its treatment.
Cancer doesn't always cause sexual dysfunction in survivors. Survivors respond to sexual dysfunction in different ways. If you are frustrated and want to find ways to manage the sexual dysfunction that you experience, this document has information that may help you.
There are many different causes for sexual dysfunction after cancer. Whether the cause is physical or emotional, there may be ways to treat and manage your sexual dysfunction. You can discuss treatment options with your health care team.
You may find it difficult to discuss sexual dysfunction with your health care team. It can feel uncomfortable or embarrassing. But your health care team can answer your questions. You can talk to them about how sexual dysfunction is affecting your life after cancer.
What are some signs of female sexual dysfunction?
Some signs of sexual dysfunction women may experience after cancer include:
- Loss of desire for sex
- Negative thoughts and feelings during sex
- Difficulty reaching climax
- Vaginal dryness and tightness
- Pain during sex or when your genital area is touched
The symptoms listed above aren't always medical emergencies. You may wonder if you should bring them up to a member of your health care team. But all of your concerns are important. If you are experiencing pain or if sexual dysfunction makes your life less enjoyable, you should discuss your concerns with a member of your health care team. You may feel more comfortable if you write down your questions before your appointment and bring them in. Your health care team can talk to you and answer your questions about all of your health problems, including sexual dysfunction.
When does female sexual dysfunction appear?
Most sexual dysfunction in cancer survivors follows cancer treatment. You may have decided that you want to wait a while after your treatment until you have sex. That is understandable. But if you want to begin having sex again and are experiencing any of the symptoms listed above, you might have a sexual problem that can be helped.
Sometimes sexual dysfunction caused by radiation to the pelvis may take longer to develop. You may not notice any dysfunction until months or years after you finish treatment. If you notice any changes in your ability to have or enjoy sex during your survivorship, you can discuss your concerns with your health care team.
What causes female sexual dysfunction after cancer?
There are many different causes of sexual dysfunction in cancer survivors. Some are physical causes and some are caused by changes in how you feel about yourself, your body or other aspects of your life after cancer.
There are certain types of cancer, like those that affect your sexual organs, that put you at risk for sexual dysfunction after cancer. About half of survivors of breast cancer or cancer in the pelvic area (cervix, ovaries, uterus, bladder, colon, and vagina) develop long-term sexual dysfunction. However, most sexual dysfunction is caused by the treatment for cancer and not the cancer itself. Even if you didn't have a type of cancer that affects your sexual organs, the treatment you received might put you at risk for sexual dysfunction.
Some of types of treatment for cancer that may cause sexual dysfunction:
- Chemotherapy can damage the ovaries, causing hormonal changes and temporary or permanent menopause in younger women (alkylating drugs are most likely to cause damage)
- Hormone therapy
- Radiation to the vagina, cervix or uterus
- Surgery or radiation therapy for cancers in the pelvic area (bladder, colorectal, cervical, ovarian, uterine, vaginal or vulvar cancer)
- Side effects of medicines used to treat pain, nausea, depression or anxiety
Sometimes cancer treatment causes physical changes in a woman's body that affect how she feels about herself or her body. This can also contribute to sexual dysfunction. Women who were uncomfortable with their sexuality or had tension in their relationship before cancer often have problems regaining a satisfying sex life after treatment. Working with a mental health professional may help improve how you feel about yourself and improve the sexual dysfunction you might be experiencing.
Some of the emotional causes for sexual dysfunction can be:
- Feeling sad or depressed
- Feeling unattractive
- Stress in your relationship with your partner
- Difficulty feeling good about yourself because of changes in your body
The table below lists more information about some of the causes of sexual dysfunction. This table doesn't provide all of the information about the many possible causes for sexual dysfunction in cancer survivors, but it does provide you with information that you may want to discuss further with your health care team.
| Physical Damage to Your Body From Cancer or Treatment |
Type of Cancer Treatment That May Cause the Damage |
Type of Sexual Dysfunction It May Cause |
|
Low testosterone levels
|
Common if a woman's cancer treatment causes premature menopause in younger women
Greater damage with higher dosages of chemotherapy, pelvic radiation, if both ovaries are removed in surgery or if a woman is over age 35
|
Loss of desire for sex
Trouble feeling excited or sexual pleasure with touch
Trouble reaching orgasm
|
|
Low estrogen levels
|
Menopause happens when the ovaries no longer make estrogen. After cancer treatment, younger women may have a sudden, early menopause.
Women who had already been in menopause but were taking estrogen replacement may need to stop this treatment if they had breast cancer
Tamoxifen, the most common hormone treatment used for breast cancer, does not decrease estrogen levels, but rather blocks estrogen from entering breast cells
Hormone therapies like raloxifene (Evista) or letrozole (Femara) may cause vaginal dryness
|
Loss of vaginal lubrication and expansion with sexual excitement. Normally as blood rushes into the vaginal walls, the lining of the vagina produces moisture and the vagina opens up, becoming a third deeper.
Lack of estrogen also causes hot flashes, which may disturb a woman's sleep, making her tired, irritable, and less interested in sex
|
|
Damage to blood flow to the vaginal walls and vulva
|
Scarring from pelvic radiation therapy can decrease blood flow to the vagina and vulva
Women who had bone marrow transplants from a donor can have vaginal scarring from graft vs. host disease
|
Dryness of the vulva and vagina
Loss of vaginal length
Slow-to-heal sores on the vaginal walls
Tight bands of scar tissue that narrow the vagina
These may all cause pain with sexual activity, especially during intercourse
|
|
Damage to the cervix or its nerve-supply
|
Radical hysterectomy removing the uterus, cervix, upper vagina, and some nearby ligaments
Some operations that include hysterectomy as well as removing the bladder and/or colon
|
Research on sex after hysterectomy does not show related sexual dysfunction
|
|
Removal of part or all of the vulva or vagina
|
Partial or total vulvectomy to treat cancer of the vulva
Partial or total vaginectomy to treat cancer of the vagina, cervix, bladder, or colon
|
Loss of pleasure with removal of areas sensitive to caressing
Pain if the vaginal entrance gets narrow with scar tissue
Lack of sexual sensations in a vagina reconstructed using other body tissues
|
Are there successful treatments for female sexual dysfunction?
There are many different treatment options that may help you with sexual dysfunction. If you think that sexual dysfunction is interfering with your ability to enjoy life after cancer, you might want to consider finding ways that you feel comfortable discussing your sexual dysfunction with your health care team. Ask for a longer appointment so you will have time to bring up sensitive questions. Sexual dysfunction may not go away on its own. Your health care team can help you learn more about the treatment options available and how to improve your ability to have and enjoy sex again.
Sometimes treatments do not work and your sexual dysfunction may continue to affect you. This can be very frustrating and upsetting for both survivors and their partners. Intercourse is only one way of sharing pleasure and closeness with your partner. Some survivors who can't have sex find they still enjoy cuddling and caressing their partner. You might want to try other ways of sharing pleasure and feeling closeness with your partner.
You have a right to sexual health, and you can work with your health care team to treat sexual dysfunction. However, you do not have to be sexually active in order to stay healthy.
What can be done to manage sexual dysfunction?
The most important factor in choosing a cancer treatment is its ability to control cancer. However, your sexual health is also important to you. If you are worried about sexual dysfunction after your treatment, talk to your health care team about different therapies. When sexual dysfunction does occur, you and your partner can overcome them with open communication and mutual affection, as well as with help from your health care team.
For more information on managing female sexual dysfunction, see Suggestions.
This document was produced in collaboration with:
Leslie R. Schover, Ph.D.
Professor of Behavioral Science, UT M. D. Anderson Cancer Center
Works Cited
American Cancer Society. "Sexuality and Cancer: For the Woman with Cancer and Her Partner." Atlanta: American Cancer Society, 2001 (99-rev. 07/01-50M-no. 4657-HCP).
Andersen, Barbara L. "Surviving Cancer: The Importance of Sexual Self-Concept." Medical and Pediatric Oncology 33 (1999): 15-23.
Ganz, Patricia, Julia A. Rowland, Katherine Desmond, et al. "Life after breast cancer: Understanding women's health-related quality of life and sexual functioning." Journal of Clinical Oncology 16 (1998): 501-14.
Grumann, Mareile, Robert Robertson, Neville F. Hacker, and Greta Sommer. "Sexual Functioning in Patients following Radical Hysterectomy for Stage IB Cancer of the Cervix." International Journal of Gynecologic Cancer 11 (2001): 372-80.
Jensen Pernille T., Mogens Groenvold, Marianne C. Klee, et al. "Longitudinal Study of Sexual Function and Vaginal Changes after Radiotherapy for Cervical Cancer." International Journal of Radiation Oncology, Biology, and Physics 56 (2003): 937-49.
National Ovarian Cancer Coalition. Ovarian Cancer: Sexuality and Intimacy. Boca Raton, FL: 2003.
Schover, Leslie. Sexuality and Fertility after Cancer. New York: John Wiley & Sons, 1997.
Email this story
|
Female Sexual Dysfunction: Suggestions
| Type of Sexual Dysfunction |
Where to Look for Help |
|
Loss of desire for sex after cancer
|
- Have a member of your health care team check your medications for possible side effects.
- Get treatment for pain that won't go away or fatigue that may be affecting your energy for sex.
- If you are in menopause, see a gynecologist or an endocrinologist for a blood test to check if your testosterone is low. Women need some testosterone for good sexual function. However, if you had breast cancer, using replacement testosterone may not be safe for you. You can discuss other options with your health care team.
- If there aren't physical causes, see a mental health professional to find out if it's related to feelings of depression, anxiety or low self-esteem.
|
|
Difficulty feeling pleasure during sex
|
- A member of your health care team may be able to recommend a mental health professional who may be able to help you. Problems with feeling turned on often are related to how you feel about yourself and to your desire to have sex.
|
|
Vaginal dryness and tightness, making sexual activity uncomfortable or painful
|
- Visit a gynecologist who specializes in women's problems with menopause or pain.
- Ask a member of your health care team, especially your gynecologist, for advice on muscle relaxation, local forms of estrogen or over-the-counter lubricants.
|
|
Orgasm problems (difficult or impossible to reach an orgasm, orgasm feels weak)
|
- Ask your health care team to look at your medications. Antidepressants or anti-anxiety medicines may make it more difficult for you to have an orgasm.
- The nerves that help a woman feel pleasure around the clitoris and in the vagina are rarely damaged by cancer treatment. This means the cancer or its treatment probably won't physically prevent you from having an orgasm. But you might want to address other issues like changes in your desire or pleasure.
- Try not to pressure yourself to have an orgasm. Sometimes this makes it hard for you to relax. Give yourself time.
|
Below is a list of some of the treatment options for sexual dysfunction and pros and cons for using them.
|
Treatment Options for Some Sexual Dysfunction
|
Pros
|
Cons
|
|
Pills for women
|
Increases vaginal lubrication without estrogen hormones.
|
Studies of PDE-5 inhibitors in women do not show a lot of change in female sexual dysfunction.
|
| Water-based lubricants |
-
Water-based lubricants last longer and work better than old-style gels.
-
Can be purchased at most drugstores or over the Internet.
-
If you are going to have intercourse, spread lubricant around vaginal entrance and head of penis, to avoid friction and pain at entry.
|
-
The lubrication may wear off and need to be re-applied during intercourse.
-
For women with severe vaginal dryness and tightness, it may not be effective enough to avoid pain.
-
Using lubricants cannot compensate for pain with deep thrusting.
|
| Vaginal moisturizers (Replens) |
-
This gel keeps the vaginal lining moist all the time.
-
Needs to be used regularly (three times a week) at bedtime for up to two months to show its full effect.
-
Some women may not need water-based lubricants for sex if they use Replens.
|
|
| Vaginal estrogen replacement (Estring, Vagifem) |
-
Some women prefer these products to vaginal estrogen cream.
-
The Estring is like the ring of a diaphragm without the cup, and releases a small dose of hormone over three months.
-
The Vagifem suppository is used a couple of times a week.
- Both produce such a low dose of estrogen that it helps ease vaginal dryness, but very little hormone gets into the bloodstream, so they are safer than pills, patches or creams.
|
Some oncologists still worry about breast cancer survivors using these products.
|
| Find comfortable positions for intercourse |
Self-help guides describe positions that may avoid pain during deep thrusting for women whose vaginas are shortened or narrowed.
|
Requires good communication between partners and being open to trying something new sexually.
|
| Learn to relax muscles around the vaginal entrance |
Self-help guides explain how to become aware of the muscles that surround the vaginal entrance, how to tense and relax them at will, and how to use the relaxation to avoid pain during penetration with intercourse.
|
Can help minimize pain, but may not relieve pain if severe scarring exists.
|
| Herbs and lotions |
Lotions may act as lubricants.
|
-
No studies have shown lotions to help with sexual dysfunction.
-
Some include menthol which makes the skin tingle.
-
Herbal remedies may interfere with a woman's other medicines, and may have unknown dangers.
|
| Clitoral pump (Eros) |
This small pump is supposed to draw blood into the clitoris, increasing sexual arousal.
|
-
No scientific evidence that it works.
-
Expensive and not covered by insurance.
-
May help women because it gives sensation similar to a vibrator.
|
When you talk to you a member of your health care team about your sexual dysfunction, they may offer different treatment options.
Email this story
|
Female Sexual Dysfunction: Additional Resources
The resources listed below provide more detailed information and support services to help you with sexual dysfunction. Please read the Detailed Information and Suggestions document for more information and questions to ask.
Click a resource for more information:
LIVESTRONG SurvivorCare Program
www.livestrong.org/survivorcare
| Email: |
Send email through the Web site. |
| Phone: |
1-866-235-7205 |
| |
Case managers take calls Monday through Friday, 9:00 a.m. to 5:00 p.m. (EST). Voicemail is available after hours. |
LIVESTRONG SurvivorCare offers assistance to all cancer survivors, including the person diagnosed, caregivers, family and friends. The program provides education, information about treatment options and new treatments in development, counseling services and assistance with financial, employment or insurance issues. To provide these services, LIVESTRONG SurvivorCare has partnered with several organizations, including CancerCare, Patient Advocate Foundation and EmergingMed.
The LIVESTRONG Survivorship Notebook is a tool that can help you organize and guide your cancer experience. The portable, three-ring binder contains a variety of information covering a full range of physical, emotional and practical survivorship topics. You may order a free LIVESTRONG Survivorship Notebook at www.livestrong.org/notebook. Shipping and handling charges will apply.
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National Cancer Institute (NCI)
www.cancer.gov
| Email: |
Send an email through the "Need Help?" section of Cancer.gov. |
| Phone: |
1-800-4-CANCER (1-800-422-6237) |
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TTY for deaf and hard of hearing callers: 1-800-332-8615 |
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English-speaking and Spanish-speaking information specialists answer calls Monday-Friday, 9:00 a.m. to 4:30 p.m. local time. |
| Online: |
Immediate online assistance is available (in English only) through LiveHelp, an instant messaging system for typing in questions and receiving responses from information specialists. You can access LiveHelp from the "Need Help?" section of the Cancer.gov homepage Monday-Friday, 9:00 a.m. to 11:00 p.m. (EST). |
Cancer.gov, the National Cancer Institute Web site, provides accurate, up-to-date information on many types of cancer and the challenges cancer can bring. You can also use the site to search for information by cancer type or topic, and you can access information about treatment-related issues. Information about financial and insurance matters is also included. You can learn how clinical trials work and search for a clinical trial in your area. This site has a detailed dictionary of cancer terms. Web site information and publications are available in Spanish.
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American Cancer Society
www.cancer.org
| Email: |
Questions can be submitted in English or Spanish from the "Contact Us" page. |
| Phone: |
1-800-ACS-2345 (1-800-227-2345) |
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TTY for deaf or hard of hearing callers: 1-866-228-4327 |
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English-speaking information specialists are available 24 hours a day. Spanish-speaking information specialists are available Monday-Friday, 6:30 a.m. to 7:00 p.m. (CST). You can leave a message in English or Spanish 24 hours a day. |
The American Cancer Society Web site contains information about many of the challenges of cancer and survivorship. You can search for information by cancer type or by topic. ACS provides a list of support groups in your area, or you can join online groups and message boards. Some information on the Web site is available in Spanish, Chinese, Korean and Vietnamese. Information specialists can answer questions 24 hours a day by phone or email.
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OncoLink
www.oncolink.org
| Email: |
Send email through the Web site. |
OncoLink is a multimedia cancer resource provided by the Abramson Cancer Center of the University of Pennsylvania. Patients and physicians can get information about all types of cancer, news about research advances, and updates on cancer treatment. The Web site includes a clinical trial matching service, answers to frequently asked questions, or you can email experts with your own personal questions. OncoLink is also available in Spanish.
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