I’m a year past lumpectomy and radiotherapy . Am 62, now on tamoxifen which I can tolerate more than alternatives . Back on vagifem but having real problems with sore vulva especially - I’m a rider and it is often agony after riding so sore. Have no libido either which is causing problems in my relationship . Tried Yes moisturisers ,
Padded pants when riding but nothing helps . Making me miserable .
Hello annasally
Thank you for posting. It is understandable that you are feeling miserable with a very sore vulva, low libido and relationship difficulties.
If it would help you to talk any of this through with a nurse, please call our free confidential helpline on 0808 800 6000
Vulval soreness and vaginal dryness, together with other menopausal symptoms, are common in women who have had or are having treatment for breast cancer. This is because some breast cancer treatments block or reduce the amount of the hormone oestrogen in the body. Oestrogen helps keep the vagina’s moisture and elasticity. A lack of it can cause the vagina and the surrounding tissues to become dry and less supple, causing pain, soreness and discomfort. This can affect the libido and also make sex or intimacy difficult.
Soreness and irritation can be very distressing and difficult to manage. If it’s not treated it can get worse, and it sounds like despite trying Yes moisturiser it hasn’t improved for you.
In addition to Yes, there are a variety of non-hormonal treatments that can help. Vaginal moisturisers can help give relief from dryness and discomfort. They should be used regularly, every few days for best effect.
Vaginal lubricants tend to be shorter acting and are either water or oil based. Lubricants are often used to help prevent friction and pain during sex and intimacy. Using a lubricant before you go riding could also help.
Moisturisers and lubricants can be used together. You may need to try a few different products to find one that suits you. You can search the manufacturer’s web site for their range of products. Manufacturers will often have several different options so it’s worth reading about how the product works, what they contain and the product reviews. Some manufacturers can provide free samples to try.
Some vaginal moisturisers contain ingredients that can cause irritation, so it’s a good idea to do a skin test on the inner and outer lips of your vagina before using any products.
If you continue to have vulval soreness and cannot find a product that suits you, you may want to talk to your GP or breast care nurse or treatment team. They may be able to refer you to a specialist menopause clinic. Vulval or vaginal soreness and irritation can also be caused by infection so it’s also a good idea to see your GP to rule this out.
The most commonly used treatment for vaginal dryness is HRT (hormone replacement therapy). HRT is not usually recommended for women after a diagnosis of breast cancer. However, some specialists will consider prescribing hormone treatments that are applied directly to the vagina (topical or vaginal oestrogen). These include oestrogen pessaries, creams or a ring.
Doctors will usually prefer you to have tried non-hormonal treatments before considering topical hormone-based treatments. As you are taking tamoxifen, your treatment team may be able to prescribe vaginal oestrogen. They could discuss the possibility of this with you.
Our booklet Your body intimacy and sex booklet also has some information about managing soreness and this Breast Cancer Now YouTube video on vaginal dryness has other suggestions which might help.
Some people may benefit from a referral to a physiotherapist specialising in pelvic problems caused by post breast cancer treatment menopause. Pelvic floor exercises can also help by increasing blood flow to the vaginal area. The links above to our information give suggestions which may help.
Many people having hormone therapy find their libido decreases. Our information on relationships and intimacy has some suggestions of things you could try. You might also find this breast cancer now facebook live on sex and intimacy helpful to watch.
We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.
As mentioned above if you would like to talk any of this through, or for more details about any of the services discussed, please see the information on the link, or call our free helpline.
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Best wishes
Angela
Breast Care Nurse
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