After your recent cancer diagnosis or treatment, you’re finally ready to be intimate with your partner. As things heat up, sex becomes uncomfortable…painful even.

Sound like an experience you’ve had?

While vaginal dryness and pain can be common side effects during and after cancer treatment, there’s good news. These issues are both treatable; there are products designed to ease discomfort and help you enjoy intimacy again.

While this may be an uncomfortable topic to discuss — with your partner or your doctor — it’s vital to understand that these symptoms can occur for a variety of reasons, including: 

• Chemotherapy and radiation therapy may damage the cells that produce vaginal lubrication

• Medications can cause vaginal dryness as a side effect

• Some cancer treatments can cause vaginal tissues to be inflamed and irritated, as well as contribute to lower estrogen (which causes vaginal dryness)

Treatment options for vaginal dryness and pain vary and include over-the-counter lubricants, vaginal moisturizers, and even estrogen therapy. Support is available to you — from Iris to your primary oncologist to support groups and even oncology-specific therapy.

Medication and hormone therapy can help some women find relief from vaginal dryness, but there are also plenty of ways to treat dryness and pain without medication. Here are just a few:

• Avoid fragranced soaps and wear cotton underwear to prevent further irritation. 

• Drink plenty of water to ensure your body is well hydrated.

• Incorporate foods rich in omega-3 fatty acids, like fish and nuts, into your diet to help improve overall vaginal health. 

If you’re finding that your symptoms are still lingering, vaginal lubricants and moisturizers can help alleviate the dryness and/or pain you’re experiencing.

In short, vaginal lubricants are designed to reduce friction and increase pleasure during sexual activity, while moisturizers are formulated to hydrate and soothe dry vaginal tissue with continual use.

Vaginal lubricants are usually water-, silicone-, or oil-based. Lubricants differ from moisturizers because they’re used only when you need them: during intimacy. They can help relieve vaginal dryness and discomfort during sex, as well as increase sexual pleasure.

Vaginal moisturizers are like body lotion for your vagina — they include creams, gels, suppositories, or oils — and are meant to be used regularly over time, requiring frequent and consistent use. 

Vaginal moisturizers help relieve dryness and discomfort all day long and during sex. Additionally, they can be used alone or with a vaginal lubricant. But keep in mind: if you stop using moisturizers, vaginal dryness will likely return.

For most women dealing with vaginal dryness or pain from cancer or cancer treatments, using a vaginal moisturizer on its own doesn’t completely eliminate the symptoms. However, a vaginal lubricant can be used in addition to the vaginal moisturizer to help improve your results. 

While both vaginal lubricants and moisturizers can provide temporary relief, they won't address the underlying cause of your dryness and pain. However, since vaginal lubricants and moisturizers don’t require a prescription, they can be purchased over the counter, so you’ll easily find these products in drugstores or online. That said, always talk to your physician before starting any new vaginal lubricant or moisturizer.

Vaginal lubricant is a clear, thin liquid that looks and feels like vaginal secretions and can help reduce dryness and pain during sexual penetration. Unlike vaginal moisturizers, lubricants are used right before sexual activity. Follow these helpful tips when you use a vaginal lubricant:

Before You Lubricate

• Communicate with your partner about why you’re using a vaginal lubricant to help with any concerns about incorporating this new product.  

Read the Label

• Find a lubricant that’s pH balanced; this will help the vagina stay slightly acidic, similar to the natural pH before menopause.

• Avoid lubricants that have perfumes, as they can irritate the lining of the vagina and vulva. 

• Avoid lubricants that contain oils or petroleum jelly (like Vaseline).

• Water or silicone-based lubricants both work well — water-based lubricants are safe to use with latex condoms or sex toys, while silicone-based lubricants are safe to use with latex condoms but can damage silicone-based sex toys.

• In some instances, and under physician guidance, coconut oil may be used as a lubricant.

• Some lubricants contain a preservative called glycerin. For some women, glycerin can increase your risk of vaginal yeast infections. 

Lubricant Application

• For vaginal penetration, spread a lot of lubricant around your vaginal entrance and vulva, as well as on your partner’s fingers, the head of your partner's penis, or the tip of a sex toy if you’re using one.

• Keep your lubricant nearby in case you need to reapply during sex. 

Vaginal moisturizers can provide essential relief and comfort from the dryness and pain you’ve been experiencing during and after cancer treatment. Follow these helpful tips when you use a vaginal moisturizer:

Read the Label

• Find a moisturizer that’s pH balanced; this will help the vagina stay slightly acidic, similar to the natural pH before menopause.

• Avoid moisturizers that have perfumes, as they can irritate the skin.

• Some moisturizers contain a preservative called glycerin. For some women, glycerin can increase your risk of vaginal yeast infections.

• Consider which application you prefer: some moisturizers are gels that use a tampon-style applicator, while others are suppositories (small tablets) that melt in the vagina. 

Moisturizer Application

• Moisturizers should be used regularly. Ideally, once every 2 to 5 days at bedtime, but nightly if your dryness is severe.

• While most use the moisturizer at bedtime, experiment with a routine that works best for you.

• After applying the moisturizer, it can be helpful to use your finger to spread the moisturizer around the entrance of your vagina, along with the inner lips of the vulva. 

Moisturizing Tips

• Some vaginal moisturizers may cause secretions from the vagina. You can use a panty liner and a sealant cream — such as Aquaphor, Desitin, or Balmex — to help protect the outer vaginal entrance from irritation.

• Talk to your doctor before incorporating any estrogen-based solutions as they may not be appropriate for everyone.

Dealing with vaginal dryness and discomfort can be a frustrating and uncomfortable experience. And if vaginal moisturizers and lubricants still aren’t cutting it, there are more options:

• Vaginal dilators: changes to the vagina (such as shortening due to cervical cancer) may require tools like a dilator to gently stretch the vaginal walls. If you’ve had radiation or surgery, it’s important to consult with your doctor or another clinician before using dilators to make sure they’re appropriate for you.

• Vaginal estrogen: with more focused effects directly in the vagina (compared to hormonal therapy), vaginal estrogen creams help to increase discharge and moisture.

Regardless of your choice for vaginal dryness and pain relief, discussing options with your doctor to weigh your unique needs is crucial. While vaginal dryness and pain can be a difficult experience for many women who have cancer or have gone through treatment, the Iris Care Team can provide many options for treatment and relief.