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Intimate Issues

Posted 5/7/2015

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  Ah, back to one of everyone's favorite topics: sexuality and intimacy. As you may know, this is a frequent conversation in my office, both with individuals and with groups, and I often give talks about the impact of cancer on sexuality. Bottom line with that one: having cancer and cancer treatment is never a sexual asset.

  For most people, the biggest issues are libido/responsiveness and, for women, vaginal dryness. Men's issues are obviously somewhat different and usually include the very obvious problems around potency and performance. To make matters worse, once a man has experienced a few disappointing attempts, it can become even more problematic as the anticipating of trouble makes things even harder (or not). For most post prostate cancer surgery or radiation, ED is very often a side effect. There are some mechanical and some medical interventions that are often useful. And this is a time for a couple to think creatively about ways to be intimate and satisfied. I had a patient some years ago whose partner became impotent after surgery. She told me that their love making was better and more satisfying than it had ever been as they learned other ways to pleasure each other and be close.

  For women, some chemo drugs and hormonal treatments and menopause combine to create a perfect storm of trouble. Some of the above advice applies as well as the need to relearn your body and what works. For vaginal dryness, there are a host of products that help. If you want the two page handout, please email me, and I will send it along: hhill@bidmc.harvard.edu

  The short answer is that there are two inexpensive, entirely non-embarrassing, and effective products to try. The first is canola oil. I first heard about this from a patient many years ago who told me that her GYN had suggested it. I called him to ask about it and why this particular oil. He said it helped many of his patients, and he just recommended canola oil, as opposed to EVO or grape oil or whatever, because a colleague had suggested it. One caveat: no sex on the beach with oil involved=a very bad match. The second terrific product is Albolene which is sold as a facial cleanser. It has the extra advantage, for some women, of almost providing an additional layer of protection between their tissue and their partner's part. If discomfort/pain is part of the problem, Ablolene may well help a lot.

  And this is a delightful article from BreastCancer.org. The information applies more widely. Here is the start and a link:

Vaginal Dryness 911: An Emergency Can Start the Conversation
By Michael Krychman, M.D.

“I’m really suffering here. How do I have that awkward conversation… you know… about dryness… with my doctor about getting help?”
I often hear this complaint from many of my brave patients who have sought help from numerous healthcare providers. Vaginal dryness in the midst of breast cancer treatment is a serious emergency, often made worse when no one is talking about it in the doctor’s office.
Many women believe that if vaginal dryness after breast cancer was an important issue they needed to know about, then their healthcare provider would have brought it up. So when it happens and there’s been no conversation or chance to prepare, that’s an emergency!
Understandably, many women remain self-conscious about initiating a dialogue with their healthcare providers. Often, healthcare professionals are poorly trained and uncomfortable themselves talking about this topic, or else they happen to be in a hurry — or both— and sometimes they may fail to address a laundry list of medical and psychological issues. Many professionals feel that if the woman herself was concerned, she would initiate the discussion.

http://community.breastcancer.org/blog/vaginal-dryness-911-an-emergency-can-start-the-conversation/

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