We get lots of calls to our Helpline about vaginal dryness but while it’s common, it can be a difficult subject to bring up. Vaginal dryness won’t get better on its own, so seeking help to manage it is important.

What causes vaginal dryness?

Some breast cancer treatments block or reduce the amount of the hormone oestrogen in your body. Because oestrogen helps maintain the vagina’s moisture and elasticity, a lack of it can cause the vagina to become dry and less supple, and may make sex or intimacy painful. If it’s not treated it can get worse, and may lead to loss of sex drive and emotional problems alongside the physical ones.

What can I do?

  • Vaginal moisturisers – such as Replens MD, Senselle or Hyalofemme – provide long-term relief for dryness and discomfort, and are not just for use during sex. You can use most types every few days, and they’re most effective when used regularly over time. Moisturisers are usually applied with a pessary (a small, soluble block that dissolves in the vagina) or tampon-style applicator.
  • Vaginal lubricants are shorter acting than moisturisers, and only provide temporary relief. They’re intended to help prevent friction and pain during sex and intimacy, and work best if used by both you and your partner. Lubricants are available as a pessary or a tube of liquid or gel. You could try Yes, Pasante TLC or Sylk.
  • Some specialists may prescribe a topical hormone treatment, which is applied directly to the area, to help reduce dryness and discomfort. This could be an oestrogen pessary, vaginal tablet or cream. If you’re taking an aromatase inhibitor, vaginal oestrogen is not usually recommended.
  • If it’s comfortable for you, sexual intercourse can stimulate blood flow to the vagina and help maintain its suppleness and elasticity. Using a vibrator or masturbating can also help in the same way.
  • Regular pelvic floor exercises can increase blood flow and relax your pelvic muscles. Knowing how to relax these muscles can help ease pain during sex or intimacy, and also help you feel more relaxed during procedures such as a smear test.

Other things that might help

  • If penetrative sex is too painful, consider other forms of intimacy.
  • Keep lubricants near the bed so you don’t have to get up to find them.
  • Don’t use scented soaps, lotions, bath oils or panty liners as these can dry out the vaginal area.
  • Try switching to a different washing powder or fabric conditioner, as some can irritate the area.
  • If you smoke, try to cut down or give up completely.
  • If you need to have a smear test and are experiencing vaginal dryness, tell the nurse or doctor beforehand so they’re aware.

Vaginal dryness and irritation can also be caused by an infection, so it’s a good idea to see your GP to rule this out.

Further information

You can read more about vaginal dryness and other menopausal symptoms in our booklet Menopausal symptoms and breast cancer. You might also find our Sex and breast cancer treatment web page useful.

We've produced a prompt list for discussions with your specialist about changes to your body, sex and intimacy following treatment for breast cancer.

If you want to talk through your concerns with one of our experts, call us free on 0808 800 600. 

This blog post is taken from the Spring edition of Vita magazine.
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