Imagine a 47 year old survivor of breast cancer. She has had chemo and radiation therapy and is now on Tamoxifen . She has gone into immediate menopause and cannot bear how her life has changed.
Mostly her sexual life. She struggles to have her partner look at her body with only one breast, she never feels in the mood for sex and when they have sex it is so painful she wants to cry out loud. She used to enjoy sex and feels as if she has been robbed of something vital.
One of the first principles to embrace in what is now being called “survivorship medicine” is that you will never be the same again. And once you can know and accept this you will be ready to adapt to the new you. The new you is now a surgically menopausal 47 year old woman with all the symptoms that come with menopause. These can include hot flashes , memory loss, urinary urge, aching joints, depression, anxiety, sleeplessness. And then the sexual and genital changes. As a direct result of this sudden depletion of primarily estrogen her vagina has lost moisture so she will not easily lubricate on her own, the lining of the epithelium is so thin that penetration will feel like a searing tearing pain. Her orgasms may have lost their va-voom or completely disappeared. And of course her libido is probably non existent. This is not a reason to give up on sexual play. Adapting requires you to eliminate the symptoms and change the very nature of your sexual relationship with both yourself and a partner.
If this is your story I urge you to spend time with your own one breasted reflection in a mirror. Touch the scar, rub oil on it, and of course caress the breast you have. To get some libido set the scene – I know it lacks spontaneity but to begin with this may the way to get you going. In a sexual scenario one can create magic with lighting, with wearing lingerie that make you feel sexy. And perfume that smells devine. The trick is to feel sexy when you don’t. I know it’s a tough call. You have a better chance of doing this well than many women who pre illness never enjoyed their sexuality.
Lets work on your vagina. Systemic estrogen replacement may be taboo for you. However there is excellent evidence that indicates local vaginal estrogen replacement is safe and works magic by bringing you a functional, juicy vagina again. Check with your oncologist and hopefully he/she will do research and if you are a good candidate for this, will prescribe a product for you. However if your oncologist is opposed to this then lets get into vaginal replenishment. Mositurizers , such as Replens, are excellent for restoring moisture into the vagina as it gets rid of dead old vaginal cells and begins to replicate your vaginal mucosa, so building up healthy vaginal cells. Instructions for use are clear in the pamphlet. In addition to a moisturizer you want to always use a lubricant for penetration and any vaginal sexual play. There are a large variety of water based lubes on the market , such as Good Clean Love, an organic natural lube or silicone lubricants such as Pjur. And then you want to ensure you have a choice of really good sex toys on hand so you are sure to have the va voom orgasm you have a right to still be enjoying. I recommend the Jimmy Jane Form 3 for clitoral stimulation as it has a perfect ergonomic design for vulva /clitoral stimulation and a self control feature that allows you to control the speed and vibration to your own requirements. Are you somewhat excited nowJ I implore you to grab your new sexuality in both your hands and feel the vitality flowing back into your estrogen depleted body!
