When asked for sex hints for breast cancer survivors, Sue—a breast
cancer survivor herself and a nurse who helps women deal with sexual
issues—said, "Astroglide, and more Astroglide. The directions say to put
it on the penis, but don't forget to smear it in the vagina, too, LOTS
OF IT."
"Being slippery is a good thing," says Dr. Margaret
Deansley, a physician, breast cancer survivor, and public speaker.
You've got to learn to use the "goop," whether it's Neutrogena Sesame
Oil, Astroglide, Today Personal, Surgilube, Ortho Gyne-Moistrin, Moist
Again, Replens, Probe, K-Y Jelly (a standard surgical lubricant),
Women's Health Institute's Lubricating Gel, or Bag Balm.
Many
women prefer Astroglide, Moist Again, the WHI Lubricating Gel (call
800-537-8658), and Probe over other products, because they spread more
easily and last longer. If your partner is using a condom, be sure to
use a WATER-based lubricant. Petroleum-based lubricants damage condoms.
Replens
is an over-the-counter moisturizer that helps the vaginal wall hold on
to water, resulting in thickened tissue that is better able to handle
the friction of intercourse. Apply it to the vagina three times a week
at bedtime, over a period of several weeks. Replens can make intercourse
tolerable, comfortable, pleasurable. In one study, 80% of women noted a
significant improvement in their symptoms with Replens. It may,
however, take months to make a difference, and you'll have to keep using
it to maintain its special benefits. It's also expensive.
Learn to use the goop without fuss or ceremony, as a matter of course. Here's how:
- Begin using it during foreplay, spreading it liberally over the
labia and clitoris and into the vagina, as well as on your partner's
parts that will enter your vagina. You may need to add more later during
intercourse.
- If you're bothered by using your hand (or your partner's) to spread
the lubricant inside your vagina, and surgical gloves don't help,
choose the product that comes with an applicator.
- You may also make your choice based on consistency, odor, or taste.
Keep a tube in the bedroom, the bathroom, anywhere you're likely to
need it.
- Try using vaginal lubricants the same way you use moisturizing hand cream: frequently and regularly.
Before attempting intercourse, it's important to feel comfortable and
relaxed, and then aroused. Some therapists suggest that couples learn
to concentrate on comfort and foreplay, and delay having intercourse for
some later time. In this way, they can establish a successful pattern
of foreplay—particularly genital foreplay—as part of their sexual
repertoire.
Foreplay is an essential factor for a woman in
becoming aroused, particularly for women who find sex painful. The
vagina produces natural lubricants, and the vaginal wall relaxes,
widens, and lengthens, allowing less painful, more satisfying
penetration. A woman is ready for sex after these changes, just as a man
is ready when he has an erection.
Viagra may be of some benefit
to women who have difficulty becoming sexually aroused. Strictly
speaking, Viagra is not an aphrodisiac, but it may help with the female
equivalent of a man's erection, sending blood to the clitoris, vulva,
and vagina. This in turn may make sex more comfortable and more
enjoyable. (If you are already having orgasms, it is unlikely to make
them more intense.) Within a few years we should have the results of
several studies looking at Viagra's value for women.
Researchers
also are studying whether a testosterone patch known as Intrinsa can
increase women's sexual desire. Preliminary research has shown some
success, but more research is needed to make sure that the higher
testosterone levels produced by the patch are not linked to a higher
risk of breast cancer.
If low libido is a problem for you, talk to your doctor. Together you can decide if medication is right for you.
If
you aren't feeling particularly attractive or sexy, your ability to
become aroused may be inhibited, or you may want to get sex over with as
soon as possible. One way to overcome this problem is to imagine
yourself as you would like to be, perhaps as some glamorous movie star
or romance-novel heroine. Mental turn-ons can be as useful as physical
ones.
Arousal can also be started and amplified by movies,
erotica, and sex gadgets. Some pretty conservative couples get positive
charging from these sources. Besides the magazines on the hard-to-reach
racks, there are how-to sex manuals—very respectable. Lonnie Barbach has
a video, Cabin Fever, especially designed for these needs: romantic,
loving, feminine. Her book Erotic Interlude has helped many patients.
What's on your mind
It's
important that you take a close look at what's happening in your head
when you have sex. Are you calling on an erotic fantasy to get you in
the mood, or are you worrying about pain or the bills you have to pay?
Switch the channels in your head; get off "This Old House" and onto
"Passion on the Waves."
Keep a journal of your moods through the
day. When do you feel the most energized? When do you fade and get
cranky? When do you think about sex? Can you detect a pattern, predict
when you'd be most likely to consider a little time between the sheets?
What about a cocktail hour escape? Or an early-morning dalliance? If
daylight inhibits you, close the curtains.
Don't count on an
exotic vacation to restart your sex life. "I can't think of a faster way
to ruin a vacation," says Dr. Leslie Schover. Take the pressure off and
take it slow. According to Dr. Schover, it's better to think in terms
of mini-vacations, short breaks in your normal routine, "like closing
the bedroom door a couple of hours earlier than usual, with a Do Not
Disturb sign hanging from the doorknob."
If you don't feel
aroused, your partner is going to feel at least somewhat responsible,
and that is going to affect his or her performance. Partners can be more
disturbed by a woman's diminished responsiveness than by the absence or
alteration of a breast.
Try new positions
Position during intercourse can be crucial.
Lying on your side, with your partner entering from behind, is
considered the least stressful to the vagina (with the least degree of
penetration compared to other positions). It also de-emphasizes the
breasts, a plus for some women.
Keep your vagina in shape
If
you want to stay sexually active or you hope to become active, you'll
need to keep your vagina lubricated and in condition. That means
stretching the vaginal canal, stimulating the membranes to produce
natural lubricants, and increasing overall elasticity and resilience.
Actual intercourse will then be more comfortable and pleasurable. (It
also makes medical pelvic examination more tolerable.) Use it or lose
it: If you don't have a partner to keep your vagina stretched and
supple, it's up to you.
Practice without a partner
If
intercourse continues to be painful, give it up for a while and practice
with a dildo, a rubber instrument with the size, shape, and consistency
of an erect penis. Don't be surprised at how realistic—veins and all—it
may look. (Different sizes, shapes, and colors are available.) It will
be more gentle, less emotionally burdensome, and perhaps fun, too. (Be
sure to use a lubricant with it.)
You can also purchase a box of
small, medium, and large hard, straight plastic vaginal dilators,
available through special-order medical supply companies. (Ask your
doctor or nurse.) Most women don't like this medical product, though,
because it's unnaturally hard, straight, and uncomfortable, and they end
up not using it.
Many stores, such as Good Vibrations in San
Francisco, California, provide mail-order catalogs and ship in a plain
brown wrapper. Started by a sex therapist determined to make vibrators
more generally accessible and available, Good Vibrations has a toll-free
telephone number and well-trained representatives who are happy to
answer questions in a straightforward, discreet, and helpful fashion
(800-289-8423).
You don't have to buy any gadgets. You can
improvise with a lubricant and an object like a candle or a suitably
shaped vegetable, wrapped in a clean plastic bag. But buying a
commercial device is often a step in the right direction because it
means you're taking this advice seriously. So find a large hat and dark
glasses and go shopping!
