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I wanted to share my experience using the PMH - Sexual Health Clinic. Warning, I'm going to be very honest about sexual dysfunction and terminology in this note. My goal is not to offend rather, to share in the event this is helpful to anyone else.

I was referred by my therapist who is also associated with PMH. I've had tremendous vaginal pain/discomfort during intercourse (yes I'm going there) and have been very concerned. Basically it felt like my someone was rubbing sandpaper into my vagina. Please note that as I went through menopause many years ago (I'm turning 60 this year), I did have vaginal dryness and have been using Vagifem inserts (very low level estrogen) for many years. These however have no longer been helping and post my OVC surgery, the symptoms had worsened. As an aside, I've also tried personal lubricants like Uberlube and Pjur Women. Both are really for external dryness.

My appointment was with Dr. Taylor Roebotham who specializes in gynecologic issues post cancer treatments. I liked her immediately. She asked many questions to understand my issues (you need to be very open and honest about sexuality so be prepared for that). After doing an internal examination she was able to immediately diagnose my issues. Yes a lot of vaginal and vulva dryness, due to lack of estrogen (age is a bitch). Plus my pelvic muscles were like strong rubber bands - very tight. Just pressing on them caused me to almost jump to the ceiling. She explained that following a total hysterectomy coupled with additional elements of my OVC surgery, the abdominal area has experienced trauma and accordingly readjusts. The pelvic muscles need to be reengaged.

The outcome was a switch in prescriptions to Intrarosa which is also a vaginal capsule however unlike Vagifem, it is soft and dissolves in order to provide moisture to both the vagina and vulva area. The downside is that I need to use it every day (at night before bed) and forever going forward (whilst I'm still sexually active). An important note is that the estrogen from Intrarosa does not go into your bloodstream and is not hormone therapy so any risks associated with it are low. It takes about 2-3 months for the body to truly adjust so I'll have to keep you posted. Also of note is that it is NOT covered by my drug plan so I have to pay out of pocket ($68/month). Yes that's a steep amount but at this point it will be worth every penny if it works. Additionally Dr. Roebotham said that both the personal lubricants I mentioned above are very good and to continue to use those.

Additionally, I was given a referral for pelvic floor physiotherapy. The goal is through exercises, to try to unlock my pelvic muscles (tensing up during intercourse is also a cause of pain). There is a website pelvichealthsolutions.ca where you can find pelvic health professionals. I found someone near to me and have an appointment in a week. Again, I will post following that appointment to share what I learned and next steps.

Ultimately for anyone reading this note, do not give up if your desire is to remain sexually active post cancer treatment. There are people to speak with and professionals who can help. More to be shared....

#Healthandwellness

Thank you for posting this information Always Learning. I have been wondering about similar issues for myself, since going through cancer treatment and surgery. As a result, the intimacy with my partner has been very infrequent, which is yet another loss in this cancer experience. My hope is that this part of our relationship can resume, as it was positive for both of us. But, I have trepidation, fearing pain. I wonder if the stitches have tightened me up even more, but this could be part of my imagination? I need to acquire some good information like you have. This might be challenging where I live on Vancouver Island, because specialized resources are not as abundant as other areas of our country. 

My body feels different since the surgery 6 weeks ago and the other day I noted that my genital area feels like sand in terms of dryness, compared to months ago before the disease. I have been post-menopausal for years (probably 10), so I understand the changes in hormonal levels and the need for lubricant. I also used Vagifem years ago, related to bladder infections. The Vagifem seemed to strengthen the tissues and I had no more issues. 

I am meeting with a gynecologist next week to check on my incision post surgery and he will do an examination. I might mention these concerns to him and see where that goes. If nowhere, I will ask him to refer me to someone who does work in this area and fingers crossed, there will be someone, somewhere. 

As a former counsellor/art therapist for teenagers, I had many conversations about sexuality with them and in my opinion, this is an important area for women of all ages. Our sexuality is a part of who we are. I also understand that this kind of openness is difficult for some because we don't get to talk about it very often, if at all. It is almost a taboo topic. 

But, I am glad you have broached this subject and explained your situation so well. It gives me (us) permission to think about this aspect of our lives and our bodies. 

Leslie 

I wanted to share my experience using the PMH - Sexual Health Clinic. Warning, I'm going to be very honest about sexual dysfunction and terminology in this note. My goal is not to offend rather, to share in the event this is helpful to anyone else.

I was referred by my therapist who is also associated with PMH. I've had tremendous vaginal pain/discomfort during intercourse (yes I'm going there) and have been very concerned. Basically it felt like my someone was rubbing sandpaper into my vagina. Please note that as I went through menopause many years ago (I'm turning 60 this year), I did have vaginal dryness and have been using Vagifem inserts (very low level estrogen) for many years. These however have no longer been helping and post my OVC surgery, the symptoms had worsened. As an aside, I've also tried personal lubricants like Uberlube and Pjur Women. Both are really for external dryness.

My appointment was with Dr. Taylor Roebotham who specializes in gynecologic issues post cancer treatments. I liked her immediately. She asked many questions to understand my issues (you need to be very open and honest about sexuality so be prepared for that). After doing an internal examination she was able to immediately diagnose my issues. Yes a lot of vaginal and vulva dryness, due to lack of estrogen (age is a bitch). Plus my pelvic muscles were like strong rubber bands - very tight. Just pressing on them caused me to almost jump to the ceiling. She explained that following a total hysterectomy coupled with additional elements of my OVC surgery, the abdominal area has experienced trauma and accordingly readjusts. The pelvic muscles need to be reengaged.

The outcome was a switch in prescriptions to Intrarosa which is also a vaginal capsule however unlike Vagifem, it is soft and dissolves in order to provide moisture to both the vagina and vulva area. The downside is that I need to use it every day (at night before bed) and forever going forward (whilst I'm still sexually active). An important note is that the estrogen from Intrarosa does not go into your bloodstream and is not hormone therapy so any risks associated with it are low. It takes about 2-3 months for the body to truly adjust so I'll have to keep you posted. Also of note is that it is NOT covered by my drug plan so I have to pay out of pocket ($68/month). Yes that's a steep amount but at this point it will be worth every penny if it works. Additionally Dr. Roebotham said that both the personal lubricants I mentioned above are very good and to continue to use those.

Additionally, I was given a referral for pelvic floor physiotherapy. The goal is through exercises, to try to unlock my pelvic muscles (tensing up during intercourse is also a cause of pain). There is a website pelvichealthsolutions.ca where you can find pelvic health professionals. I found someone near to me and have an appointment in a week. Again, I will post following that appointment to share what I learned and next steps.

Ultimately for anyone reading this note, do not give up if your desire is to remain sexually active post cancer treatment. There are people to speak with and professionals who can help. More to be shared....

#Healthandwellness