Dr. Machelle Seibel and Colleagues Help Cancer Patients Ease Vaginal Dryness and Painful Sex: A Side Effect of Estrogen Depleting Drugs, Chemotherapy and Surgery

One of the most common and painful side effects of cancer treatment is vaginal dryness and many women who are receiving chemotherapy or who are taking drugs such as Tamoxifen, Raloxifene, and aromatase inhibitors, may find themselves living with discomfort. The problem can be especially troubling as estrogen therapy is usually not an option for these women.

Within a short window of only three to six months, vaginal dryness can lead to painful sex, according to Dr. Murray Freedman of Medical College of Georgia at a North American Menopause Society (NAMS) meeting. The reason is atrophic (aye-TROE-fick) vaginitis, the medical term for thinning of the walls of the vagina and skin of the intimate areas around the vagina that can lead to vaginal narrowing and dryness of the vagina with an increased tendency to urinary symptoms.


“Keeping sexually active helps maintain the vaginal wall tissues,” says Dr. Machelle Seibel, a Massachusetts complicated menopause expert and Professor at the University of Massachusetts Medical School. “Unfortunately sex can hurt and women with this condition suffer a great deal, especially cancer patients who typically can’t use a hormone cream. Those that can use estrogen locally derive a great deal of benefit because it can reverse the atrophic changes. But some estrogen will be absorbed into the bloodstream causing many oncologists to withhold it. That’s why it’s important to discuss non-hormonal treatments with your doctor.”

During the NAMS plenary session entitled, When Sex Hurts, Dr. Raquel Arias of the University of Southern California discussed treatment options and various types of non-estrogenic interventions like lubricants, Replens moisturizer and acidifying gels for vaginal atrophy and dyspareunia in women with breast cancer.


Many women don’t understand that lubricants and vaginal moisturizers are not at all the same. Traditional lubes and even olive oil can temporarily relieve discomfort during sexual intercourse but will do little to heal chronic dryness, restore the vaginal pH or the structure of the tissue. But, Replens is a long lasting moisturizer and a good non-hormonal alternative to estrogen for easing vaginal dryness and alleviating painful sex. Symptoms of thinning vaginal tissues include irritation, itching, burning and soreness. If left untreated, this condition can lead vulvar vaginal atrophy and painful sex.


“The most important thing to realize is that atrophic vaginitis is the most common symptom of natural menopause and extremely common in breast cancer survivors. A variety of treatments for atrophic vaginitis are available. Talking with your doctor early is the best way to manage these symptoms, because otherwise, over time, the problem will get worse,” adds Dr. Seibel.


As a Wall Street Journal article stated, “The battle is over estrogen.” Although women often loath mentioning it, eliminating estrogen also creates sexual issues, particularly vaginal dryness. With time, “the hot flashes get better, but the vaginal dryness gets worse,” says Mary Jane Minkin, a professor of obstetrics and gynecology at Yale University School of Medicine.


As a cancer survivor, I sure have firsthand experience with this issue. So, please pass my sexy secret along.

With love,

Suzi Kirsh