Many women with breast cancer, including mothers, are treated with medications that block estrogen and leave their vaginas tight, dry and inflamed. They feel helpless and are afraid that anything that will heal their vagina may cause a recurrence of their breast cancer. But, there are several new therapies that are safe for breast cancer survivors to use that will help thicken the vaginal wall and make intercourse more pliable.
Dr. Neysa Whiteman is a Board Certified Ob/Gyn who is on the board of BioMoi, which helps women impacted by illness, trauma and more.
I had a chance to inter Dr. Whiteman to learn about options women have.
1. How do estrogen levels affect women’s discomfort during intercourse?
Estrogen is vital to the health of the vaginal tissue; it helps keep the vaginal skin thicker and more pliable. Estrogen is a hormone that is mostly made in the ovaries. In women who have lost their ovaries or who are post-menopausal, estrogen levels drop. Over time, in some women, as the vaginal skin gets thinner and less elastic, this can lead to feelings of vaginal dryness and tightening. Sometimes this is more pronounced in women who have never given birth vaginally. As the problem progresses, women may complain of painful intercourse with feelings of burning or tearing, feeling like sandpaper or knives. Not fun. The bladder may come into play with more frequent infections after intercourse. The pain may then linger for days after intercourse. A woman who experiences painful intercourse (called dyspareunia) tends to avoid sex, and this leads to further tightening of the vagina and potentially stress on her relationship with her partner. The longer she neglects the problem, the worse it can get, and then more work and time is involved to get back to normal function. The North American Menopause Society says that 17 to 40% of post-menopausal women have painful intercourse.
2. What are some things that women can do?
The first step is often to find a lubricant. There are many products available— water-based products are good and coconut oil is also a favorite. Second, there are vaginal moisturizers that last longer and help with symptoms that are not just associated with intercourse. If these over-the-counter aids are not enough, there are many prescription options.
There are many choices when it comes to vaginal estrogen replacement. And, remember, the concept of vaginal estrogen replacement is that the amounts that are used are enough to keep the vagina thicker and more pliable, but not enough to raise your blood levels. So, despite what the black warning in the package insert says, if used as directed, they will not give you vaginal bleeding, blood clots, or breast cancer.
Vaginal estrogen is available in a vaginal cream, tablet, suppository, and ring.
There is also systemic hormone replacement that will help the vagina but, even with HRT, 25% of women will still need to boost their vagina.
Another hormonal option is DHEA suppositories. DHEA is an adrenal hormone that is converted into estrogen and testosterone within the cells of the vulva and vagina. A non-hormonal option is Ospemifene—this is an oral pill that stimulates the estrogen receptors in the vagina, but not the estrogen receptors of the uterus or breast.
Lastly, vaginal dilators are a non-hormonal option to help relieve painful intercourse. They can be used on their own with lubricants or in concert with medications to help relieve the atrophy. Dilators help to slowly stretch the tissue without causing pain and tearing.
There are many other “tricks of the trade,” and a visit with your physician may help you decide which course of action will be right for you.
3. How can vaginal dilators help?
A vaginal dilator, sometimes called a vaginal trainer, is a non-hormonal way to gently stretch the vaginal opening and the vagina to help make intercourse more comfortable. Once the dilator is coated with lubricant and the woman is relaxed and comfortable, she can very slowly and gently insert the dilator without causing pain. The trick is to start with a size that is not too big. The plan is to slowly stretch the vagina for maybe 5 or 10 minutes a day or every other day. It's important to go at your own pace so there is no ripping, tearing, or pain. Once the vagina is large enough to accommodate her partner, having intercourse twice a week should keep everything working well. If necessary, one can also continue to use the dilator as needed.
4. What sets BioMoi apart from other options?
BioMoi is the only vaginal dilator that is antimicrobial. It is made of medical grade silicone that is combined with an antimicrobial agent. The antimicrobial agent is combined into the entire dilator so that it will not wear out or rub off. The dilator is designed to be flexible and soft to the touch—so it should be comfortable and not scary. BioMoi is well priced and available in sets of graduated sizes or as individual dilators. You can learn more at https://biomoimedical.com/.
Dr. Neysa Whiteman
She trained in Los Angeles at UCLA, USC and Kaiser. She joined a practice in Orange County in 1984 and practiced Obstetrics and Gynecology. In 1990 she moved to San Diego and limited her practice to gynecology. She sees herself as an advocate for women and enjoys working to solve their health care concerns during the different phases of their life. In the past few years, she has become especially concerned with menopause and the vaginal changes it can cause. With so many advances in that arena, it is particularly rewarding to be able to help women improve their sexual life.
BioMoi
BioMoi’s vision is to provide women with the best quality of vaginal dilators on the market. BioMoi™ has deliberately specified dilators made of US Platinum silicone designed to offer a smooth glide into the vaginal opening. The design and material have been carefully chosen to help women reclaim the right to fulfilling their sexuality. In addition, BioMoi’s vaginal dilators come in a variety of sizes to compliment each women’s body and therapy for vaginal tightness and pelvic pain.
BioMoi™ are in partnership with BioCote®, the market leader in antimicrobial solutions. The BioCote® technology integrated throughout BioMoi™ vaginal dilators compliments hygiene by actively reducing microbes on the surface of the dilator, keeping them fresher for longer.*
BioCote® antimicrobial technology reduces over 99% of microbes such as bacteria and mold that can cause odors and staining on the BioMoi dilators. It does not leach, wash off or wear away, but will provide lasting protection for the expected lifetime of the vaginal dilators. This added level of protection makes BioMoi’s vaginal dilators the only antimicrobial dilators available, and the best choice for women looking to reclaim their sexuality.
*BioCote® technology does not protect users or others against disease-causing bacteria, germs, viruses or other harmful organisms. This technology is not a substitute for good hygiene and/or cleaning practices.
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