Breast Cancer Survivor’s Vagina Wishlist

• Stay sexually active during breast cancer treatment—try “me-only” nights!
• Only attempt sexual intercourse with a lubricant after 4-6 weeks rehabilitation; pain begets pain
• Use different sexual positions that stress the vagina less—penis points down first rather than in and up
• Attempt sexual intercourse with high arousal—immediately before rather than after orgasm
• Lubricate the vulva and vagina to add and seal in moisture—Uberlube (silicone based) or coconut oil.
• Vitamin E used on vulva and at vestibule ( vaginal entrance entrance) twice a week (use the capsule form)
• Avoid soaps and chemicals (feminine products) on vulva
• Hygiene Stretch in shower—press downward against the perineum (area between vagina and anus)
• Massage the vulva and vaginal opening by using a press and release method—minimizes friction, brings blood flow to the area, 12:00 to 12:00, include clitoris, labia—daily for 5 minutes
• Perineum massage—lubricate thumb and index finger, press/swipe lower crescent of vestibule pressing on muscles toward anus, the goal is flexibility versus stretching the skin
• Enjoy 2 orgasms a week!
• Try stretching with sexual arousal for further gain in flexibility
• Kegel exercises—to strengthen and tighten the pelvic floor. Be sure to relax: open, open, open—have your Gynecologist check for relaxation
• Use vibrating massager—to increase skin strength; include internal wands or dildos
• Referral to Pelvic Floor Physical Therapist for secondary vaginismus, friable/fragile tissue, pelvic tension
• Exercise to a sweat multiple days a week for health and blood flow
• Eat a healthy diet including: fish oil, Omega-3 fatty acids, Vitamin E, (clear w/physician first), low sugar
• Have sex within 30 minutes of exercise—easier arousal
• Consider Viagra or Viagra (prescription required) cream for increased blood flow during love-making
• Try Scream Cream (prescription required)—contains vasodilators, contra-indicated if you have herpes
• Beware OTC cold medications that could dry your vaginal tissue; review all medications for sexual side effects
• Condoms add friction—switch birth control with monogamous partners (vasectomy!) Always protect with new partners but use liberal lubrication!!!
• Estrogen—titrated dose prescribed by your doctor (contra-indicated for ER positive breast cancer)

Normal
Extensive rehabilitation before comfortable vaginal penetration

Not normal
No orgasm, large vaginal tears