10 tips for vaginal atrophy (pain)
For people with a vagina during (and even long after) cancer treatments, penetration can hurt, even when using lubricants. The words ‘sandpaper’, ‘burning’ and ‘glass shards’ are just a few (accurate) descriptors of the pain. I'm talking about what is called 'vaginal atrophy' and is a very common and very debilitating side-effect from cancer treatments.
Simply put, ‘vaginal atrophy’ means the walls of your vagina are getting dry & thin due to oestrogen changes and dehydration. The 'sandpaper' feeling is a normal side-effect from various treatments which could include chemotherapy, hormone therapy, radiotherapy and more. As your internal tissues are a bit roughed up, dry and tender, they’ll need some time and attention to heal recover.
Here are some things you can do!
1. STOP!
Please avoid penetrative sex while it hurts, as you'll only make it worse if you push through the pain and then you'll start to associate sex with pain…. which you really don't want (there are plenty of other ways to have sex)! This is how our desire decreases also, when we have penetrative sex because we ‘should’ and when it becomes something to be ‘endured’. For more information on desire and libido recovery, click here.
2. Chat
Your oncologist or gynaecologist are your go to for help. They know your treatment, your body, your cancer and they know what is safe. Please don’t put up with it, as there are ways to treat it, you just need to ask! And there are other possibilities around atrophy such as vulva eczema or lichen sclerosis, so seeing a professional is important for your recovery and well-being.
3. Moisturise
Just like we moistures our hands when they’re dry and cracked, you'll need to moisturise your vagina. And regularly. There are internal moisturisers of all brands and types, shop around and find what suits you! For information on the vaginal dryness, click here.
If you have a hormone positive cancer, chat to your oncologist before choosing one, as some moisturisers have hormones in them. It’s important you talk about what’s safe for you, relative to your cancer and your treatments.
4. Walk
Light exercise such as walking puts your pelvis in motion and gets blood circulating. It may seem strange, but this can have great benefits for your vaginal tissues, as blood flow is our body's way to heal! Try 15-20 minutes per day of brisk walking, but remember anything is better than nothing, so even 5-10 minutes a day will help!
5. Pleasure
I’m serious, I want you to self pleasure. Not internally though as it might cause you more pain and increase tissue damage. I mean pleasure yourself externally. Clitoral stimulation, anal stimulation and other erogenous zones. Arousal gets blood to the deep tissues inside our pelvis and around our genitals and is excellent for healing those tissues.
Having difficulties getting aroused on your treatments/meds? Use a vibrator on your clitoris and anus (check out these video resources for more info on that!). They work a treat and remember, you can have sex and pleasure without having to be penetrated, especially while it hurts.
6. Lube
If you do want to internally explore, use a silicone lubricant.
Water based lubricants are safe and common, however, as our bodies are designed to need water, water-based lubes get absorbed into our bodies SUPER fast. And if you are already a little dry internally (dehydration from treatments/meds) your body will absorb it like a sponge!
Silicon based lubes are great. Due to not being water based, they last way longer, don’t get absorbed into the body and can feel incredibly delicious. Click here for more information on the various types of lubricants and which one is best when.
Disclaimer: ‘Lubricants’ are a viscous liquid that reduce friction by making two surfaces that rub together slippery. ‘Moisturisers’ are exactly that, moisturisers. So they have different purposes. If you have painful penetration when you use lube, it means you may need a moisturiser and some time to heal. Chat with your treating team. ('Uberlube' and 'Sliquid Silver' are amazing silicone lubricants)
7. Bathe
I’m not kidding, a warm soak in the bath does wonders for the body. It relaxes the muscles, the joints and gets blood to the internal tissues. Noticing a theme here? Don't have a bath? Pop a warm wheat-pack or warm-water bottle between your legs. It will still get the blood flowing and help heal. Blood is everything!
8. Oil
Not only can we have internal atrophy, but we can also externally. The tissues on your labia and around the vaginal entrance can be sore also. Applying some organic coconut oil on your genitals after the shower can help replenish the tissues and ease pain (noting that a very small percentage of the population can get thrush from organic coconut oil, so test a dab out on your belly/inner thigh to look for any reactions first). Some people also use organic coconut oil internally as a substitute for an internal moisturiser. Find what's right for you!
9. Underwear
Breathable, natural and comfortable underwear is important. I switched to 100% natural bamboo underwear as cotton was too painful for my vulva pain as I got to the point where I could barely walk. We’re all different, so try a few things out. When I found the right brand for me, I nearly cried from the relief from the pain when I put them on.
10. Allied Health
Not only do you have your oncologist, gynaecologist and other specialists on your side, but there are also pelvic floor physiotherapists, osteopaths and occupational therapists who specialise in this! You do not have to do this alone! Click here for more information on all things intimacy and cancer.
I won’t lie or minimise the reality of this as it’s awful and can be very, very debilitating day to day. It’s just one more thing we have to take care of, one more thing in our endless self-care regime of trying to regain anything resembling our old lives.
Think of it this way, what you’re experiencing is normal. I’m sorry, but think about it. Your body is undergoing/recovering from cancer treatments, which change how your body functions physiologically. The changes in your energy, pain, appetite, libido/desire, sleep, memory AND your genitals, are normal reactions to the abnormal things that are happening in your body from treatments.
Try some of the above things out, talk to your treating team and find support.
You are normal, you are not broken, you are not alone.
...
If you're after information on all things intimacy and cancer, see the Intimacy & Cancer the Book.
If you're impacted by cancer and need support regarding the more 'intimate' struggles we face, join the private facebook group: 'Intimacy and Cancer' for support with thousands of people diagnosed with cancer, from over 35 countries.
Simply put, ‘vaginal atrophy’ means the walls of your vagina are getting dry & thin due to oestrogen changes and dehydration. The 'sandpaper' feeling is a normal side-effect from various treatments which could include chemotherapy, hormone therapy, radiotherapy and more. As your internal tissues are a bit roughed up, dry and tender, they’ll need some time and attention to heal recover.
Here are some things you can do!
1. STOP!
Please avoid penetrative sex while it hurts, as you'll only make it worse if you push through the pain and then you'll start to associate sex with pain…. which you really don't want (there are plenty of other ways to have sex)! This is how our desire decreases also, when we have penetrative sex because we ‘should’ and when it becomes something to be ‘endured’. For more information on desire and libido recovery, click here.
2. Chat
Your oncologist or gynaecologist are your go to for help. They know your treatment, your body, your cancer and they know what is safe. Please don’t put up with it, as there are ways to treat it, you just need to ask! And there are other possibilities around atrophy such as vulva eczema or lichen sclerosis, so seeing a professional is important for your recovery and well-being.
3. Moisturise
Just like we moistures our hands when they’re dry and cracked, you'll need to moisturise your vagina. And regularly. There are internal moisturisers of all brands and types, shop around and find what suits you! For information on the vaginal dryness, click here.
If you have a hormone positive cancer, chat to your oncologist before choosing one, as some moisturisers have hormones in them. It’s important you talk about what’s safe for you, relative to your cancer and your treatments.
4. Walk
Light exercise such as walking puts your pelvis in motion and gets blood circulating. It may seem strange, but this can have great benefits for your vaginal tissues, as blood flow is our body's way to heal! Try 15-20 minutes per day of brisk walking, but remember anything is better than nothing, so even 5-10 minutes a day will help!
5. Pleasure
I’m serious, I want you to self pleasure. Not internally though as it might cause you more pain and increase tissue damage. I mean pleasure yourself externally. Clitoral stimulation, anal stimulation and other erogenous zones. Arousal gets blood to the deep tissues inside our pelvis and around our genitals and is excellent for healing those tissues.
Having difficulties getting aroused on your treatments/meds? Use a vibrator on your clitoris and anus (check out these video resources for more info on that!). They work a treat and remember, you can have sex and pleasure without having to be penetrated, especially while it hurts.
6. Lube
If you do want to internally explore, use a silicone lubricant.
Water based lubricants are safe and common, however, as our bodies are designed to need water, water-based lubes get absorbed into our bodies SUPER fast. And if you are already a little dry internally (dehydration from treatments/meds) your body will absorb it like a sponge!
Silicon based lubes are great. Due to not being water based, they last way longer, don’t get absorbed into the body and can feel incredibly delicious. Click here for more information on the various types of lubricants and which one is best when.
Disclaimer: ‘Lubricants’ are a viscous liquid that reduce friction by making two surfaces that rub together slippery. ‘Moisturisers’ are exactly that, moisturisers. So they have different purposes. If you have painful penetration when you use lube, it means you may need a moisturiser and some time to heal. Chat with your treating team. ('Uberlube' and 'Sliquid Silver' are amazing silicone lubricants)
7. Bathe
I’m not kidding, a warm soak in the bath does wonders for the body. It relaxes the muscles, the joints and gets blood to the internal tissues. Noticing a theme here? Don't have a bath? Pop a warm wheat-pack or warm-water bottle between your legs. It will still get the blood flowing and help heal. Blood is everything!
8. Oil
Not only can we have internal atrophy, but we can also externally. The tissues on your labia and around the vaginal entrance can be sore also. Applying some organic coconut oil on your genitals after the shower can help replenish the tissues and ease pain (noting that a very small percentage of the population can get thrush from organic coconut oil, so test a dab out on your belly/inner thigh to look for any reactions first). Some people also use organic coconut oil internally as a substitute for an internal moisturiser. Find what's right for you!
9. Underwear
Breathable, natural and comfortable underwear is important. I switched to 100% natural bamboo underwear as cotton was too painful for my vulva pain as I got to the point where I could barely walk. We’re all different, so try a few things out. When I found the right brand for me, I nearly cried from the relief from the pain when I put them on.
10. Allied Health
Not only do you have your oncologist, gynaecologist and other specialists on your side, but there are also pelvic floor physiotherapists, osteopaths and occupational therapists who specialise in this! You do not have to do this alone! Click here for more information on all things intimacy and cancer.
I won’t lie or minimise the reality of this as it’s awful and can be very, very debilitating day to day. It’s just one more thing we have to take care of, one more thing in our endless self-care regime of trying to regain anything resembling our old lives.
Think of it this way, what you’re experiencing is normal. I’m sorry, but think about it. Your body is undergoing/recovering from cancer treatments, which change how your body functions physiologically. The changes in your energy, pain, appetite, libido/desire, sleep, memory AND your genitals, are normal reactions to the abnormal things that are happening in your body from treatments.
Try some of the above things out, talk to your treating team and find support.
You are normal, you are not broken, you are not alone.
...
If you're after information on all things intimacy and cancer, see the Intimacy & Cancer the Book.
If you're impacted by cancer and need support regarding the more 'intimate' struggles we face, join the private facebook group: 'Intimacy and Cancer' for support with thousands of people diagnosed with cancer, from over 35 countries.
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