Elephants And Tea - September 2021 - 13

INTIMATE ISSUES WITH MARLOE Sexuality
Why Sexual Pain Happens After
Cancer, and What Can be Done
MARLOE ESCH, BSN, RN, OCN, CSC
DISCLAIMER
DISCLAIMER
This information is not
a substitute for medical
care. Always inform
your healthcare team
of any concerning
symptoms you are
experiencing, and
consult with your
provider before initiating
new treatments,
therapies, or health
routines.
IF YOU EXPERIENCE DISCOMFORT WITH SEXUAL ACTIVITY, YOU'RE NOT
ALONE. Sexual pain happens to be the most commonly reported sexual complaint for women
after cancer (Bober & Krapf, 2021). Sometimes referred to as dyspareunia, painful sex can vary
from mildly uncomfortable to wildly debilitating. This type of pain can be an acute (early onset)
side effect of some cancer treatments, or it can develop as a late-effect. Either way, symptoms
can worsen over time if they're not addressed.
Let's review some of the common causes for pain with sexual activity after cancer, as
well as some strategies available to prevent and manage this problematic survivorship
issue. The name of the game should be pleasure, not pain!
SEXUAL PAIN AFTER CANCER MIGHT BE RELATED TO...
Changes in hormone levels.
Estrogen loss is the most likely cause of discomfort with sexual activity after cancer (American
Cancer Society, 2021). Premenopausal levels of estrogen contribute to a happy, healthy,
vulvovaginal environment by promoting blood flow to the area and keeping the vaginal tissues
stretchy and well-lubricated.
Chemotherapy, endocrine therapy (such as tamoxifen, aromatase inhibitors, or ovarian
suppression), pelvic radiation, and surgical removal of your ovaries (oophorectomy),
can all lead to a sudden drop in estrogen production and cause bothersome menopausal
symptoms. Low estrogen levels contribute to vulvovaginal changes such as tissue thinning,
loss of elasticity, and dryness, which can lead to irritation and pain with sexual activity.
Changes after pelvic surgery or radiation.
When healing after pelvic surgery or radiation, vaginal tissues can develop fibrosis and scarring.
This reduces the stretchy, elastic characteristics that help to make sex comfortable, and
can cause the vagina to become shorter and narrower (called vaginal stenosis). Pelvic surgery
and radiation can also damage the nerves and blood supply to the reproductive organs and
genitals, contributing to vaginal dryness and altered genital sensation.
MARLOE ESCH, RN, BSN, ONCOLOGY CERTIFIED NURSE (OCN), AND YOUNG ADULT
CANCER SURVIVOR, GRADUATED FROM THE UNIVERSITY OF WISCONSIN - MADISON
SCHOOL OF NURSING (GO BADGERS!) IN 2008. SHE ENJOYS EDUCATING BOTH
SURVIVORS AND HEALTHCARE PROFESSIONALS ON THE TOPIC OF CANCER AND
SEXUALITY, AND HAS PRESENTED FOR THE YOUNG SURVIVAL COALITION, THE
ONCOLOGY NURSING SOCIETY, AND PLANNED PARENTHOOD OF WI, AMONG
OTHERS. SHE HOLDS A CERTIFICATE FROM THE SEXUAL HEALTH CERTIFICATE
PROGRAM THROUGH THE UNIVERSITY OF MICHIGAN AND IS CURRENTLY PURSUING
HER DOCTOR OF NURSING PRACTICE (DNP) AT THE UNIVERSITY OF WISCONSIN -
MILWAUKEE. AN ENTHUSIASTIC SUPPORTER OF SEXUAL HEALTH AND WELLNESS,
MARLOE IS MAKING IT HER MISSION TO BRING SEX INTO THE SURVIVORSHIP
SPOTLIGHT.
ELEPHANTSANDTEA.COM
SEPTEMBER 2021
13
https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer/problems.html https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer/problems.html http://www.ELEPHANTSANDTEA.COM

Elephants And Tea - September 2021

Table of Contents for the Digital Edition of Elephants And Tea - September 2021

Contents
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