Help for dryness ‘down there’

Q:

I’m 47 and just finished chemotherapy and radiation for breast cancer. My doctor prescribed medication to lower my estrogen levels, but she didn’t tell me one of the side effects of these treatments can be vaginal dryness. It feels like a deep chafing—it’s so painful. What can I do?

A:

I’m sorry that after all the treatments you’ve been through, you’re now dealing with this intrusive aftermath. Both chemotherapy and the medication you’re taking decrease levels of circulating estrogen, which can cause the vaginal walls to become thin, dry and inflamed. In fact, atrophic vaginitis, which causes symptoms including dryness, irritation, itching, burning, pain, soreness and discharge, affects nearly 70% of postmenopausal breast cancer survivors and 50% of postmenopausal women. And a recent survey shows that only one out of four oncologists treat their patients for this, and only when the patient asks.

To calm symptoms, I advise avoiding products in the vaginal area that can lead to further irritation, like douches and scented panty liners, lotions or soaps. It can be helpful to apply a vaginal moisturizer (like Chiavaye Personal Moisturizer or Replens) two to four times a week at bedtime to hydrate the cells of the vagina and maintain a healthy balance of bacteria.

And even though sex may be the last thing you feel like doing, studies show that regular sexual activity stimulates blood flow to the area and can improve vaginal health. Since you have pain, I suggest applying a topical anesthetic ointment with 5% lidocaine externally, at the opening of the vagina, an hour before being intimate. Then use a silicone lubricant. If you are still hurting after taking these measures, talk to your doctor about other options.