A Survivor Shares The Hardest Part Of Sex After Breast Cancer

Photographed By Lauren Perlstein.
This article was originally published on October 30, 2015.

Breast cancer and its treatments wreak all sorts of havoc on the body. Survivors (a group that includes me) know that hair falls out from chemotherapy, skin gets burned from radiation, and breasts never look or feel the same again. We call this “collateral damage.” But we’re rarely warned about other brutal symptoms: vaginal dryness, itching, burning, and painful intercourse, which can mess with our sex lives for years.

Once my battle with breast cancer was over, I thought that the tough stuff was behind me. Boy, was I wrong. I soon learned that survival comes at a physical — and emotional — price that I hadn’t expected. It was hard enough to adjust to the weird implants from surgery, thicker waistline and hot flashes from hormone therapy, and some very unflattering curls from chemo. But a dry vagina, too? You’ve got to be kidding me, I thought. “Cancer surgery and treatments force women into early menopause,” says Jian Jenny Tang, MD, assistant professor of obstetrics and gynecology at New York City’s Icahn School of Medicine at Mount Sinai. “The ovaries stop producing estrogen, so the vaginal tissue gets thinner and the glands produce less mucus. It’s a big concern.”

Survival comes at a physical — and emotional — price. But a dry vagina, too? You've got to be kidding me.

As a young, single survivor, this side effect was especially worrisome to me. I started getting nervous about how I was going to introduce lube into a romantic situation and feeling self-conscious about having a vagina that felt like 20 years my senior. Lucky for me, I had a positive first foray back into sex thanks to plenty of lube — but I wanted a longer-term fix.

When I went to my gynecologist, she recommended an estrogen-based lubricant or an estrogen ring that is inserted to restore moisture for three months. Because I had an estrogen-sensitive cancer, though, my oncologist nixed that option. I also wasn’t a candidate for vaginal prolapse surgery, because it’s reserved for those with very severe cases of atrophy. “Treatment options are very limited,” Dr. Tang tells me — no kidding.
Photographed By Lauren Perlstein.
But there is hope on the horizon for survivors like me. In 2011, the FDA approved the use of the FemiLift Laser, a CO2 fractional ablative laser that’s inserted into the vagina and uses thermal heat to create micro-sized dots of trauma in the vaginal tissue. As the tissue begins to heal, it produces more collagen and becomes tighter, thicker, stronger, and more hydrated. Translation: It fixes incontinence, dryness, looseness, and the uncomfortable sex that can accompany all of these symptoms. (The FDA approved a laser that targets vaginal atrophy, MonaLisa Touch, last year.)

The thought of using a laser in the vagina is cringe-worthy, but facts are overriding the fear. “The inside of the vagina does not have nerve endings the way the outside — like the clitoris and vaginal skin — does,” says Eskandar J. Simhaee, MD, a gynecologist who uses the laser in his practice at North Shore University Hospital in Manhasset, NY. “The 5- to 10-minute procedure is pain-free” without anesthesia, he says. Patients must wait four days before having sex, but can return to normal activities — including exercise — almost immediately after each Femilift session. For those who are sick of doing daily Kegels, wearing pads for leakage, or having to lube up for sex, “This laser is a game-changer,” Dr. Simhaee says.

The thought of using a laser in the vagina is cringe-worthy, but facts are overriding the fear.

To get the word about FemiLift out to cancer survivors this Breast Cancer Awareness month, the United Breast Cancer Foundation teamed up with Cindy Barshop, the founder of VSpot Medi-Spa, which uses the FemiLift Laser in its vaginal rejuvenation treatments. If anyone can draw attention to this technology, it’s Barshop. The straight-shooting New Yorker (and Real Housewives of New York alum) and is no stranger to vagina talk. She founded Completely Bare, a laser hair-removal business that helped make Brazilians mainstream and revolutionize the way women thought and talked about grooming pubic hair. Now with VSpot, Barshop’s focusing even more on women’s sexual health and satisfaction. “Nobody talks about the vagina after breast cancer,” she says. “But being able to feel sexy and be intimate again is emotionally and physically vital for survivors.”

So far, the only reported downside of the FemiLift Laser treatments is the cost, which ranges from $850 to $1150 per session and isn’t covered by insurance. I haven't received the treatment; if I could afford it, I would. Hopefully, insurance will start to cover it in the future. In the meantime, Barshop is offering a free first treatment to survivors, as well as a package of four sessions for $2,950 (while three treatments are recommended, Barshop believes that four are needed to achieve optimal results). Click through to VSpot Medi-Spa to book a session or to learn more about the treatment that could transform the sex lives of cancer survivors.

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