Elephants and Tea - September 2021 - 14

Sexuality INTIMATE ISSUES WITH MARLOE
CHECK OUT THESE
RESOURCES!
* American Association
for Sexuality Educators, Counselors,
and Therapists (AASECT)
- www.aasect.org
Search for medical and mental
health professionals in your area
that are certified in sexuality education,
counseling, or therapy.
* American Cancer Society - Managing
Female Sexual Problems
with Cancer - https://www.cancer.
org/treatment/treatments-andside-effects/physical-side-effects/
fertility-and-sexual-side-effects/
sexuality-for-women-with-cancer/
problems.html
*
ChoosePT - https://www.choosept.
com/Default.aspx
A website by the American Physical
Therapy Association with information
about physical therapy. Use
the search tool to find a therapist
in your area who specializes in
sexual health, pelvic floor health, or
pelvic pain.
* Elephants and Tea - Used to
Feel So Good, Now it Feels SO
Baaaaad...(The Vulvovaginal
Blues), by Marloe Esch - https://
elephantsandtea.com/sexuality/
used-to-feel-so-good-now-it-feelsso-baaaaad/
*
Memorial Sloan Kettering Cancer
Center - How to Use a Vaginal
Dilator - https://www.mskcc.org/
cancer-care/patient-education/
how-use-vaginal-dilator
* A Woman's Touch Sexuality
Resource Center - https://sexualityresources.com/
A
sexual health store and educational
website with a lot of great information
on different sexual topics
(try searching " othercourse " ), and
where you can purchase sexual
aids and personal lubricants.
* Ohnut - http://ohnut.co
Graft-Versus-Host Disease (GVHD).
Women who undergo allogeneic hematopoietic stem cell transplants are at risk for developing GVHD,
a condition where the transplanted cells attack and damage a person's organs and tissues. GVHD can
affect the tissues of the genitals and reproductive tract. Symptoms may be mild or more severe, and
can include vulvovaginal dryness, inflammation, and pain with sexual activity. Over time, vaginal
stenosis may develop. Vulvovaginal GVHD requires different types of management than some other
causes for sexual pain. Ask your care team if this could be a cause of your symptoms.
Muscle tension and spasm.
The pelvic floor muscles stretch from our tailbone to our pubic bone, creating a supportive muscular
structure for our pelvic organs. This group of muscles also surrounds the vaginal and urethral openings
and the anus, playing an important role in control of the bladder and bowel, as well as sexual function.
Just like other muscles, pelvic floor muscles can become injured, weakened, chronically tense
(hypertonic), or experience spasms. The term vaginismus is sometimes used to describe the
involuntary contractions of these muscles that make vaginal penetration during sex difficult,
or even impossible. If you've ever had a painful cramp in your calf muscle, it's like that, but in
your genitals - ouch!
STRATEGIES FOR SUCCESSFULLY OVERCOMING SEXUAL PAIN
Ask your provider for a thorough assessment and physical examination.
Deciphering the reasons for discomfort with sex can be a bit tricky, because there are often multiple
factors at play. Plus, different causes of pain require different types of treatment. The expertise of a
professional is important for making sure that your symptoms are being managed appropriately.
Once you report your symptoms, your nurse or provider will probably ask for some details.
Would you describe the pain as soreness, burning, stabbing, shooting, tingling? Is it generalized
or localized? Is it more external (vulvar) or internal (pelvic or vaginal)? When does it start, and
how long does it last? What seems to help, and what seems to make it worse?
A physical examination should also be completed, and additional laboratory tests or imaging
exams may be ordered based on findings of the assessment and exam. For example, sometimes
urinary tract infections (UTIs), sexually transmitted infection (STIs), and yeast infections can
contribute to sexual pain. These underlying conditions should either be ruled out or treated.
Simple adjustments to your sexual routine can help.
First, it's important to communicate with your partner about what you are experiencing and when, as
well as what makes your symptoms better or worse. Genital sensation may have changed with cancer
treatment, and you and your partner may need to explore how new types of touch make you feel.
Also, always make sure you're adequately aroused before attempting vaginal intercourse.
Your body's sexual arousal response (the changes that help make penetration comfortable, like
increased vaginal lubrication and expansion of the vaginal canal), can take longer after cancer
treatments. Slowing down and letting your body get into the groove can really help.
Another thing you can do at home is experiment with different positions for vaginal intercourse,
especially ones that allow you to be the person that controls movement. There are some
great ideas (and illustrations!) on The American Cancer Society's website.
Sexual aids can also help. Using pillows or specialized cushions for positioning can change
the angle and improve comfort. Ohnut is another inventive product that can reduce pelvic discomfort
with vaginal intercourse by allowing women and their partners to use stretchy, cushy
rings to buffer against deep penetration.
Additionally, if vaginal intercourse hurts, think outside the box! There are lots of fun and
sexy things to do that don't involve penetration. Check out some ideas from the experts at A
Woman's Touch.
Try over-the-counter (OTC) vaginal moisturizers and personal lubricants.
Non-prescription topical options are first-line treatment for survivors experiencing sexual discomfort
due to vulvovaginal atrophic changes and dryness (Carter et al., 2018; NCCN, 2021). These include
regular maintenance with vaginal moisturizers, and the use of personal lubricants with sexual activity.
14
ELEPHANTSANDTEA.COM
SEPTEMBER 2021

http://www.aasect.org 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 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 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 https://www.choosept.com/Default.aspx https://www.choosept.com/Default.aspx https://www.elephantsandtea.com/sexuality/speaking-of-sex/ https://www.elephantsandtea.com/sexuality/used-to-feel-so-good-now-it-feels-so-baaaaad/ https://www.elephantsandtea.com/sexuality/used-to-feel-so-good-now-it-feels-so-baaaaad/ https://www.elephantsandtea.com/sexuality/used-to-feel-so-good-now-it-feels-so-baaaaad/ https://www.elephantsandtea.com/sexuality/used-to-feel-so-good-now-it-feels-so-baaaaad/ https://www.mskcc.org/cancer-care/patient-education/how-use-vaginal-dilator https://www.mskcc.org/cancer-care/patient-education/how-use-vaginal-dilator 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.mskcc.org/cancer-care/patient-education/how-use-vaginal-dilator https://www.ohnut.co/ https://www.sexualityresources.com/ https://www.sexualityresources.com/ https://www.sexualityresources.com/sites/default/files/documents/Othercourse17_0.pdf http://www.ohnut.co https://www.ascopubs.org/doi/10.1200/JCO.2017.75.8995 http://www.ELEPHANTSANDTEA.COM

Elephants and Tea - September 2021

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