Menopause and Sexual Changes

Menopause, also called “the change of life,” is the body’s response to lower amounts of female hormones

Drugs used to treat breast cancer can cause the change of life to start early (some women have a brief time without menstruation, and others stop altogether). Symptoms of the change may include vaginal dryness, pain during sex, changes in the ability to have children, and vaginal and urinary tract infections. A greater risk for bone loss and heart disease also comes with menopause. These problems can be more severe than changes that occur naturally without drugs.

A Warning About Hormone Replacement Therapy (HRT)

Many women get Hormone Replacement Therapy (HRT) to deal with symptoms of menopause. However, since estrogen helps some breast cancers to grow, HRT is generally NOT suggested for breast cancer patients. Be sure all your doctors are aware you are a breast cancer survivor. Talk to your doctors (primary doctor, gynecologist and oncologist) before taking any medicines or herbs to help with any symptoms you are having. You may hear of products that are said to be safe to use instead of hormones. Some act in the body like estrogen. Their safety after breast cancer has not been shown. Additionally, talk to your doctor about eating or drinking food made from soy. They contain phyto-estrogens, meaning they can act in the body like estrogen.

Dealing with Hot Flashes

  • If your hot flashes really bother you, talk to your doctor. There are medicines that help with hot flashes and are safe after breast cancer. Medications such as Effexor® have been shown to reduce hot flashes for breast cancer survivors.
  • Dress in layers, so you can remove them at the first sign of a flash.
  • Dress in loose clothing made of natural fibers (cotton).
  • Drink a glass of cold water or juice at the start of a flash.
  • Keep a spray bottle and fan nearby so you can mist and fan yourself to cool down quickly.
  • At night, keep a thermos of ice water or an ice pack by your bed, and sleep with a fan on the nightstand or keep the ceiling fan on.
  • Use cotton sheets and night gowns or pajamas to let your skin “breathe.” Be sure you can remove layers of covers as well.
  • Avoid hot spicy foods and alcohol. They start hot flashes in some people.
  • Keep a diary of your hot flashes. Note the time of day and what you were doing prior to the hot flash. You may be able to find what triggers your hot flashes. If you find something that you do or eat is a trigger, then avoid it.
  • Exercise regularly.
  • Try stress relief techniques.
  • Vitamin E seems to help some women with hot flashes, but it can be toxic in high doses. Always talk to your doctor about what dose is right for you before you try Vitamin E supplements.
  • Vitamin B12 tablets also seem to help some women with hot flashes, but as with any medication, discuss with your doctor before beginning a new medication.
  • At night, try sleeping with your covers untucked. This will allow you to get your hands and/or feet out of the cover, as soon as you feel a hot flash coming on. You lose most of your body heat from your hands and feet.
  • Acupuncture has been shown to help women who suffer with hot flashes by reducing their intensity and occurrence.

Dealing with Vaginal Dryness

  • Use water-based lubricants such as K-Y Jelly (Johnson & Johnson), Astroglide (Astro-Lube, Inc.), Pre-Seed® (much like your natural lubrication) or Replens (Parke-Davis).
  • Do not use oil-based lubricants such as Vaseline or baby oil because they cause irritation to the vagina.
  • Check with your doctor about using a non-estrogen based cream or gel. Many doctors wait for you to ask about these issues, so don’t be afraid to discuss this with them. Some oncologists feel that manually applying a small amount of estrogen cream is safe. Your medical oncologist should be the physician to approve and prescribe vaginal estrogen creams. Estring® was shown to have virtually no impact on blood estrogen levels, and may be a good option for women. Additionally, women taking Tamoxifen are better able to use these medications, as the Tamoxifen blocks all estrogen in the body.
  • Take things slowly. If you take a little more time, your body has time to stretch and work on its own.

Dealing with Pain During Sex:

  • Take the time to try different positions. After surgery, some women prefer that their spouse or partner’s weight does not rest on them.
  • Think about making love in a side-by-side position. Try other ways that may not be painful.
  • Reduce weight on your surgical site to decrease pain. Support yourself with pillows for comfort.
  • Take pain medicine before having sex if needed.
  • If your pain is related to muscle spasms, consult your doctor for any therapies they might suggest.

Dealing with Fatigue and Sex:

  • Be flexible about the time of day you make love. Choose a time you’re less tired and have more energy.
  • Try less demanding positions. Discuss with your spouse or partner that making love need not start with a long session.

When Do You Need to Seek Help?

Talk to your health care team if your hot flashes bother you and you have tried the tips listed above. When it comes to sex, you need to be able to talk openly with your spouse or partner. If you have trouble discussing these issues, consider seeing a professional counselor or support group that addresses these topics. These issues are very common among breast cancer survivors, so don’t feel like you are alone.

Useful Websites:

Menopause Symptoms: Hot Flashes 10 Ways to Cope with Hot Flashes with Breast Cancer

Sexual Topics

American Cancer Society/Cancer, Sex and Sexuality

National Cancer Institute: Sexual and Fertility Problems (Women)

SelfImage and Sexuality in Your Sex Life

WebMD/Sex Complaints Common After Breast Cancer

Louisiana's Young Breast Cancer Survivor Network

Young women with breast cancer face unique issues. And in the South, there are more young women overall facing breast cancer. In Louisiana, young African-American women are significantly more likely to suffer from breast cancer.

That is why SurviveDAT is here. Part of the Gulf States Young Breast Cancer Survivor Network, SurviveDAT's mission is to help improve the quality of life for young breast cancer survivors, as well as their family and friends, by providing continuing resources and support.

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