You’ve passed the hurdle and triumphed over the Big C. With the feeling of new beginnings and a second chance at life, chances are you haven’t allowed yourself to start thinking about the aftershocks just yet. And while the relief of receiving the official ‘Cancer Free’ stamp is unlike any other feeling, once the celebrations are over, the reality is that it doesn’t quite stop there… A number of issues linger even after remission.
One such issue is returning to a normal sex life. Along with the various side effects of treatment is the impact on sexual health. It’s important to remember that whether physical or psychological, the effects of cancer and cancer treatment need to be tackled head-on. Sex might not seem like a priority after what you’ve been though, but returning to a normal life is the right of any survivor.
What you might not know is that chemotherapy, radiation and various cancer medications can contribute to changes in sexual functions in women. Chemo and radiation can cause damage to the ovaries, which in turn may accelerate menopause, even in younger women. Temporary or permanent menopause leads to vaginal dryness, which can cause pain during sexual penetration and general discomfort. Radiation may also cause scarring or fibrosis of the vaginal walls, which over time will decrease the vagina’s ability to expand when sexually stimulated.
There is also the possibility of vaginal atrophy, which is the inflammation and thinning of tissue, triggered by lower levels of oestrogen present in the vagina. And cancer medications used to address nausea and pain may lower libido. Surgery has its complications too. Women undergoing even a partial mastectomy may find the receptiveness of their nipples to be significantly reduced. Removal of sexual organs, like the ovaries, can also bring about early menopause.
But the impact of cancer on quality of life is not exclusively physical. Cancer sufferers often experience bouts of anxiety and this can make its way to the bedroom. It’s important to remember that sexuality goes further than the act of sex itself. While sex can be an amazing way of relieving stress, for cancer patients this is often easier said than done. Women can experience negative feelings during sex, difficulty being pleasured and the inability to climax. The effects of cancer treatment on weight, skin and hair can also produce feelings of embarrassment and inadequacy. These concerns, paired with vaginal dryness and tightness, can strain a woman’s sexual life and impact her relationships greatly.
How To Survive The Psychological Pitfalls
Moving forward from cancer starts with identifying the problems the disease has left behind and then taking action to move beyond it. Some survivors seek support from their doctor, partner, family or other survivors. Just being around loved ones can dramatically improve mental well-being, which in turn will contribute towards a better, more positive self-image. A medical specialist will be able to prescribe treatment where necessary for severe anxiety, depression and lowered libido.
Treating Vaginal Dryness
Vaginal dryness is a common result of treatment, particularly in women who have been thrown into menopause. There are numerous options available to those suffering from vaginal dryness in general, though as a cancer survivor, some of these options may be unsuitable and it’s essential to seek medical advice before trying anything. Vaginal moisturisers and lubricants are often used to combat dryness – these are topical treatments that can be applied when required. Though effective for some, in severe cases these treatments are just not enough.
To combat the lower levels of collagen in the vaginal tissue, oestrogen replacement treatments may be prescribed in small doses. This has proven to be helpful for treating vaginal dryness and tightness, though some oncologists still discourage survivors of breast cancer and some types of ovarian cancer from using this method. Even with a low dose, oestrogen can escape into the bloodstream and in turn nourish cancer cells that may still be in the body.
A procedure that is gaining traction is fractional CO2 laser, which is used in a process called ‘vaginal rejuvenation’ by some. “The laser is used on the inside of the vagina as well as on the vulva. The process requires the laser to create tiny holes in the mucous membrane, triggering a healing process in the area. Through this, new collagen and blood vessels are produced, alleviating dryness and eliminating pain,” explains aesthetic gynaecologist Dr Natalia Novikova, who practises in both Johannesburg and Cape Town. Around three sessions are recommended, spaced four to six weeks apart. The procedure is safe for patients in remission and has proven to yield significant results. “A specialist will assess the need for the patient, as for some, the dryness is not severe enough to require laser therapy. In these cases, I would usually suggest a lubricant or hyaluronic acid-based vaginal gel,” says Novikova.
Another treatment for vaginal dryness, which is suitable for cancer survivors, is a PRP (platelet-rich plasma) injection into the vaginal skin. Another name for this procedure is the O-shot as it’s used to enhance orgasms as well. Blood is taken from the patient and spun with a few natural ingredients to stabilise growth factors and enrich them.
What About Vaginal Laxity
Vaginal laxity results in less friction during intercourse, which takes away from the pleasurable experience of sex a fair bit. Tackling laxity is also possible through CO2 laser, though treatment may require a few more sessions than treatment for dryness. The collagen production which is achieved strengthens the vaginal wall, combating looseness effectively. Another common method is through pelvic-floor training and Kegel exercises to strengthen pelvic muscles. Over time, and with a consistent regimen, the strengthened muscles will contribute to vaginal tightening.
It’s important to remember that as a cancer survivor you have options. If you’ve managed to show cancer the door, you are more than capable of overcoming these challenges. Don’t let treatable issues keep you from living your best life and take the steps to help yourself. Whether it’s medical treatment or counselling, seek out the solution that suits you and your sexual needs best. Remember, every cancer journey is different so the journey after remission will be too.