Hormones and the Reproductive System

Changes in desire as well as physical changes may occur with a number of cancer treatments. Menopause triggered by cancer treatment, plays a role in complicating and adding to this issue.  I rely on several of the suggestions outlined below to help things along.

Menopause

After my first dose of a triple combination of traditional chemotherapies I was thrown into menopause. I could not take HRT (Hormone Replacement Therapy) to offset the effects of a rapid transition into menopause. A tumor sensitivity profile including hormone assessment should be a topic of discussion with both your Oncologist and Gynecologist..

Recommendations

• Ask to have your tumor tested to see if it has any hormonal sensitivities.

• Discuss your symptoms with your Gynecologist.

• Check with your Oncologist BEFORE using any systemic (ie oral) hormone-based prescription drugs or taking any over-the-counter menopause assistance supplements.

• Localized minimal dosage (ie Vagifem {prescription}) of hormones can help lessen the effects (ie dryness, thinning of vaginal tissue integrity).

• Estroven (over-the-counter) is a systemic treatment for hot flash relief. You may need to take it for a few weeks before you notice a difference. 

• Be aware that tofu, edamame (soy beans), soy milk, etc all contain estrogen-like or mimicking substances that can possibly stimulate tumor growth if your tumor has hormonal sensitivities. Limit soy intake intake as much as you can.
  
  

Difficulties Enjoying Sex

(NOTE: This section may be a little too explicit for some people)

Having sexual relations, especially for women, may be a bit more problematic for a number of reasons while being treated with certain chemotherapies or targeted treatment regimens. There are a number of reasons causing this issue, let alone desire itself being squelched.  Early menopause or hormonal changes may be triggered by cancer treatment causing vaginal tissue and vaginal walls to become thinner, as well as vaginal dryness due to lack of natural lubrication; both issues can cause pain during sex.

 In addition, your immune response has been dampened so minor infections that your body naturally fought off previously may be more of an issue. Infections such as UTI, yeast infections, etc. may occur more frequently. Certain targeted treatment and chemotherapy combinations can exacerbate many aspects related to the epidermis and skin / tissues. The below suggestions may help avoid pain and stress for both parties.

Recommendations

• Foreplay and partner patience is even more important for a successful and more pleasurable interlude. Spontaneity may take a bit of a backseat to planning so both partners can more fully enjoy the experience.

• Beforehand, if possible, try to cleanse yourself front and back to minimize the presence of normal flora, bacteria (ie Shower together?)

• Liberal use of a water based lubrication inside and around the area is highly recommended. Be sure to also lubricate the area at the lower portion of your vagina near the bridge to the anal area as that portion of tissue is more delicate. ie. Sliquid or Astroglide

• Slowly using a long style vibrator or dildo helps open up, stretch the interior of the vagina and dilate your vagina as well and makes way for an easier and less painful penetration by your partner. Consider incorporating it as a part of your foreplay.

• Go slowly as your tissues are more delicate and are more likely to tear.

• After having sex, pass urine to cleanse the urethra which might help to minimize the occurrence of a urinary tract infection.

• It is important to cleanse yourself before and after having sex with a mild soap and water rinse as just using a damp cloth may otherwise spread bacteria around the area.

• If you dont feel up to having sex, cuddling, back rubs, head rubs, foot rubs, kissing  or caressing sessions are alternatives methods of connecting with your partner . Giving permission to each other for pleasuring him / her is a lovely way to reassure, connect with him/her as well, as sex and intimacy is often lost in the onslaught of treatment.

Vaginal Dryness / Thinner Tissues

Recommendations

Your Gynecologist can prescribe an insert called Vagifem (twice weekly) which is a locally placed, low level amount of female hormone. It is not a systemic treatment but helps preserve, maintain and perhaps helps to build up the interior wall thickness to a more normal but still lower level in the vagina. 

Obtain a medium sized syringe body (ie approx. 2 inch) and plunger from your GP or OB / GYN and use it to place a portion of lubrication fluid ( ie Astroglide etc.) inside your vagina prior to penetration. (Be careful it doesn't leak out.) Clean your syringe and plunger after each use, inside and out.

Yeast Infections / Bacterial Vaginosis

Yeast infections can occur more frequently as your immune system may be out of kilter. This type of infection may occur even if it isn’t triggered by having sex.

Recommendations

• Probiotics may help keep yeast infections at bay in addition to helping keep your gut flora in balance.

• It is important to cleanse yourself before and after having sex with a mild soap and water rinse as using a damp cloth might just spread bacteria around the area.

• Use of a condom may help as semen is basic thus may promote bacterial growth.

• Monistat is often effective. Complete the full treatment regimen.

• Drink cranberry juice, low-sugar version, as the acidic level may help to deter bacterial growth.