How to Relieve Painful Sex for Cancer Survivors?

Worldwide, breast cancer is the most common invasive cancer in women. The United States has the highest annual incidence in the world, about 125 per 100,000. The lifetime risk is 1 in 8 women (1).

Thanks to medical advancement, about 90% of women today can survive breast cancer after treatment (2).

However, nearly all survivors must endure a significant side effect of the treatment―vaginal atrophy―with vaginal dryness, painful sex, and sexual dysfunction (3).

The cause is reduction of estrogen (4).

Estrogen supports woman’s reproductive tissues

The female reproductive hormone estrogen supports the development and wellbeing of woman’s reproductive tissues. These tissues include breasts, ovaries, the uterus, and vagina (5). A healthy reproductive-aged woman has a high level of estrogen. Her vaginal lining is thick and well developed (6).

After menopause, estrogen declines, but not diminished

After a woman reaches menopause, the production of estrogen in the ovaries declines (7). However, the overall estrogen level does not reduce abruptly because adrenal glands and fat cells also produce estrogen (8). As a result, after menopause, a healthy woman can still produce a low level of estrogen to maintain the wellbeing of reproductive tissues and bone health (9). The production of estrogen reduces with aging, but it does not stop even the woman is 80 years old.

Breast cancer treatment

When a woman develops estrogen-sensitive breast cancer, a common treatment is anti-estrogen therapy (10).  It includes medications like Tamoxifen, and/or an aromatase inhibitor. The duration is five years.

Tamoxifen works by competing with estrogen for receptors in breast cancer cells to suppress cancer growth. However, it can block the estrogen effect on normal cells, such as the cells in the vaginal tissue.

Aromatase, also called estrogen synthase, is an enzyme responsible to produce estrogen. It is found in tissues where estrogen is made, including ovaries, adrenal glands, and fat cells.

Left: The healthy vaginal lining has multiple layers of superficial cells. Right: after breast cancer treatment, the vagnial tissue shrinks and only 1 layer of superficial cells remain.

When Tamoxifen and/or aromatase inhibitors are used, the woman’s estrogen loses effect, or estrogen production stops. As a result, many side effects associated with declining estrogen may appear, such as osteoporosis, joint disorders, and vaginal atrophy.

What are the symptoms of vaginal atrophy?

Vaginal atrophy may cause a range of symptoms. These include vaginal dryness, atrophy (tissue shrinkage with reduced elasticity), painful intercourse, itching, and burning. Vaginal atrophy reduces tissue resistance against infections. As a result, recurrent bacterial vaginosis (BV) and chronic urinary tract infections (UTIs) are common in breast cancer survivors (11).

Vaginal dryness and painful sex are major signs of vaginal atrophy

Vaginal atrophy in healthy women vs. breast cancer survivors

In healthy women, vaginal atrophy may develop after menopause. The cause is the aging-related reduction of estrogen. The estrogen level is only partially decreased, but not diminished. A low level of estrogen is produced even in a woman of 80 years old. Vaginal atrophy can be treated both by estrogen supplementation and by non-estrogen methods. Recovery is often fast and readily achievable.

In breast cancer survivors who have had antiestrogen therapy, vaginal atrophy is often more severe (12). The cause is artificial estrogen suppression. As a result, women’s internal estrogen is rendered ineffective, and/or its production is completely shut off. Estrogen supplementation cannot be used to treat vaginal atrophy. It can only be treated with non-estrogen methods. Recovery is often slow and difficult.

What are complications of vaginal atrophy?

Vaginal atrophy increases your risk of:

Vaginal infections, especially BV. The thinning of the vaginal skin reduces the normal vaginal cell exfoliation. The vaginal acid balance changes to a higher pH. These changes in the vagina make vaginal infections more likely.

Urinary tract infections (UTIs). Reduced estrogen can cause the thining of the inner skin of the bladder. It also increases the bacterial load in the vagina, which is a reservoir for bacteria to cause chronic UTIs. You might experience increased frequency or urgency of urination or burn with urination. Some women experience more urinary tract infections or urine leakage (incontinence).

Treatment options for painful sex in breast cancer survivors

Estrogen supplement cannot be used in breast cancer survivors because it promotes the recurrence of breast cancer. The only treatment options are non-estrogen methods. These include three categories:

1. Energy-based devices

Several energy-based devices are available in selected OG/GYN clinics to perform intravaginal treatment for “rejuvenation” purposes. These devices use radiofrequency or laser to generate heat or micro-injuries in deep tissue. Micro injuries can trigger a “wound-healing” effect. New tissues may grow up during the healing process and help regrow the atrophied vaginal tissue. The brand names of these devices include:

MonaLisa Touch

ThermiVa

FemiLift

Viveve

Votiva

Since these devices do not use estrogen, many breast cancer survivors have tried them. While these treatments can provide good relief, there are some problems.

One problem is accessibility. These devices are high-priced heavy-duty equipment that is not widely available. You cannot buy one and do a self-treatment by yourself. You need to visit an OB/GYN clinic where it is available. Not all clinics in your area have one.

Another problem is the cost. For one set of treatments, it costs about $2,500. Insurance does not cover it (13). Many breast cancer survivors cannot afford it.

The third problem is the short-lived effect. They all claim that one treatment can provide relief of one year (14). This may be for a woman with mild to moderate vaginal atrophy. However, many breast cancer survivors have severe vaginal atrophy and they reported that the effect only lasted for 3 months. After 3 months, atrophy returned, and they would need a second set of treatments.  Therefore, for the effect to last about one year, multiple treatments may be needed. This further jack up the cost.

Realizing some of the problems, the US Food and Drug Administration (FDA) issued a warning letter about these devices:

2. Nutritional supplements

Menopause causes osteoporosis due to the reduction of estrogen (15). Estrogen supplement can reverse osteoporosis, but it has a cancer risk. A safer method to reverse osteoporosis is taking calcium and vitamin D3 and K2 pills (16). This method is called nutritional supplements. To date, millions of post-menopausal women are doing just that and have achieved overwhelming success.

Likewise, vaginal atrophy can also be relieved by nutritional supplements. It includes two categories: topical nourishment and dietary supplement.

2A. Topical nourishment

When estrogen is reduced, nutrients allocated to the reproductive tissues, like the vagina, are reduced, causing it to become atrophied. Therefore, delivering either estrogen or nutrients to the vaginal skin tissue can reverse vaginal atrophy.

NeuEve products are for self-treatment of vaginal atrophy. They deliver skin-rejuvenating nutrients, like vitamins, minerals, and fatty acids. The nutrients promote the growth of collagen and elastin fibers in the thinned vaginal skin (17).

Topical nourishment can enrich these fibers, making the thin skin to grow thicker, more elastic, and resilient. The process is like putting cream on the face to smooth wrinkles.

NeuEve has three levels of suppositories and one cream. Breast cancer survivors can start with a combination of NeuEve Silk suppository and vulva balm cream for a speedy recovery.

The method is to insert a suppository intravaginally once every 4 days. Apply the NeuEve Cream a tiny bit (a dime size) daily on the external vulva. To reverse vaginal atrophy caused by breast cancer treatment takes time. It may take 1-4 months depending on how severe the atrophy is.

2B. Dietary supplement

Topical nourishment can be highly effective due to direct skin absorption. However, if the atrophy is severe, only limited nutrients can reach deep tissues from the skin surface. Combining with dietary supplements can work better. The dietary supplement pills include:

2Ba. Calcium, magnesium, and vitamins D3+K2 pills

These are the most important supplements that all breast cancer survivors need to take. Without vitamins D3 and K2, calcium and magnesium may not be absorbed and deposited at the right place (18). Calcium is essential not only for bones but also for mucus gland secretions (19). One of the major side effects of anti-estrogen therapy is osteoporosis (20). However, unlike vaginal dryness, osteoporosis is not readily visible until a fracture occurs. If osteoporosis is not managed, mucus glands throughout the body can be dried out. The fact that most breast cancer survivors have severe vaginal dryness indicates severe osteoporosis. All breast cancer survivors should take these supplements to prevent osteoporosis before unexpected fractures occur (21).

2Bb. Fish oil pills

Omega-3 and 6 fatty acids are important dietary fats and are a crucial part of human cell membranes. They have health benefits to support the bone density (22) and wellbeing of the vaginal lining skin (23). Fish oil is a rich source of Omega-3 and 6. However, if you do not like fish, you can take flaxseed oil pills instead. Also, eat a lot of fish routinely if you like to eat fish.

2Bc. Sea buckthorn oil pills

Omega-7 is an important fatty acid that helps you revive dried mucus glands and keep moisture in the oral cavity, eyes, and vagina. Sea buckthorn oil is a major source of Omega-7. A clinical study showed that taking sea buckthorn oil pills helps relieve vaginal dryness (24) You can find this supplement on our webpage.

3. Dilation exercise

While you are using NeuEve Silk and Cream, you can do the dilation exercise to speed up the healing process.

Dilation is another self-treatment method for vaginal atrophy (25).

You might have seen handicapped people sitting in a wheelchair with thin legs. Their leg muscles shrink after disusing. If one day they can stand up, they must do walking exercises to grow back their leg muscles. This means that exercise is important and useful.

Physically stretching the skin promotes its elasticity and durability. It is done by promoting the synthesis of elastin and collagen fibers. Dilation with a set of dilators can help strengthen weak skin. A clinical trial study showed that practicing dilation exercise effectively reduces vaginal atrophy in breast cancer survivors undergoing aromatase treatment (26). You can find a set of dilators from this link www.neueve.com/dilators.

Magnetic dilators of VuvaTech

Once you are on the product webpage, you can click the “Learn More” button. It will lead you to the VuvaTech website.

We recommend magnetic dilators. Magnets in the dilator may help stimulate the atrophied tissue to grow thicker and more resilient (27).

You can start from a small-sized dilator and do dilations twice a day (morning and evening) and 20 minutes each. After 1-2 weeks, you may move up a size.

Once you move up to the largest size without pain, your skin will be strong enough to endure the stretch caused by sex. Your vaginal atrophy will be healed and you may no longer experience the tearing and pain during intercourse.

In summary, using NeuEve Silk and Cream, oral nutritional supplements, and dilation exercise can help breast cancer survivors find relief from severe vaginal atrophy safely. However, the recovery may take some time. Please be patient to allow these methods to work for you.

Can NeuEve be used by women with active breast cancer?

NeuEve is all-natural, hormones free, herbs free, and yam free. It works by
providing essential nutrients to the atrophied vaginal soft tissue. Essential
nutrients include vitamins and minerals, without which in the diet humans
cannot survive. The difference is that NeuEve delivers them to the atrophied vaginal tissue, like nutrient facial cream for stopping wrinkles on the face (atrophy of the skin). Therefore, NeuEve is safe.

Since NeuEve is hormone-free, technically it does not interfere with breast cancer treatment. However, we do not recommend women with active breast cancer to use NeuEve before their cancer is in remission. Due to recent advancements in medicine, the breast cancer cure rate has improved a lot, but it is not yet 100% (28). If by any chance the cancer is not completely cured or it recurs later, the oncologist might blame on other things that the patient has used.

If you have active breast cancer, we suggest that you focus on the
cancer treatment first. Once your cancer is in remission, you can use NeuEve without any worries. The appropriate products for relieving vaginal atrophy for breast cancer survivors are NeuEve Silk, NeuEve vulva balm cream, dilators, and nutritional supplements as described above.

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Customer reviews on NeuEve from cancer survivors

Allison Watson

August 20, 2020

I ordered these for my mother-in-law, and this is what she has to say:

“My urologist told me to get these! I was having constant UTI’s for the past few years, I am 58 and after being diagnosed with breast cancer at 49 and then being told to have my ovaries removed too. I had everything taken out except my vagina. After that, it was much too painful for any of that kind of fun!

I do believe in miracles and maybe your product will make it possible again!!!

Your product has made me feel so much better! I do not have the horrible feeling of getting a UTI anymore or any dryness and not one UTI since I started!!! Which is huge!!! So, thank you for caring enough for women’s health to make such a wonderful product!!!

This is such a hard subject to discuss no one talks about it and not something I normally would but I think I need to tell you it is working so far! The price is high, but I will just have to save somewhere else!!!

It has been about 6 weeks since I started, and I can feel the walls of my vagina are starting to soften which had hardened (I have even had surgery to clip scar tissue that was like rings closing my vagina) I didn’t even know if I could get one of your suppositories in!!! But had no problems!!!

I felt I needed to write this because it is the first thing that has worked!!! I am not sure I would have tried this because of the price if my doctor had not told me to. I think if you were to give some samples to doctors so more women could try them. More women would be using them even if they tried them once they could see how they could change their lives too!!!

Please know you really are helping women like me and I just have to say Thank you again!!!”

Lyfeizgudd

Definitely helped with my problem

Reviewed in the United States on May 12, 2019

I am 59 years old and the last couple of years have been more torture than pleasure when it came to intimacy. I think my husband thought I no longer found him attractive- or worse. The truth is that sex became so painful I began to dread it.

I have breast cancer in my family and longed for something to help. I stumbled upon these with an internet search and the reviews were great! I noticed an improvement after the first suppository. I am on my third month now. I started with wild, then silver, and recently have purchased gold.

I did not give 5 stars because it is pricey and while the scent is not offensive, I do not really care for it. Also, after three months, I cannot say I am pain-free exactly, but I have seen a major improvement in my sex life.

Bluesinthenight

It works for vaginal atrophy!

Reviewed in the United States on September 15, 2017

I developed vaginal atrophy after chemotherapy for breast cancer. Because of my breast cancer, I am unable to use estrogen suppositories. I had despaired of ever having painless sex with my husband until I tried NeuEve. It works!

I am now able to have sex without pain or using other lubricants. It is nothing short of amazing. For those that complained of some discharge after use, I suggest using a panty liner. It is completely worth it. Insertion is easy with or without an applicator, but I suggest remaining lying down completely still for at least 15 minutes after insertion.

I have found that even pulling on my panties can cause it to slip out. I also find it is best used when I go to bed, so it has all night to work its wonders. I am 66 and have not been able to have painless sex in 15 years. This is a miracle. I plan to move on to the Silver Kit.

lablover53132

Reviewed in the United States on February 7, 2017

I am a young cancer survivor that was forced into menopause early from my cancer treatments. This is the only product that has worked long term for me.

I struggled with BV issues for some time and obviously vaginal atrophy from pelvic radiation, since using this product I have not had one single reoccurrence of BV. I have since recommended this product to a few of my friends all of whom are either pre-or post-menopausal with similar issues (odd odor, less natural lubrication) and they all seem to love it and recommend it.

I would say initially I was skeptical; I have been using this for about 6 months and my honest opinion is that this product is exactly what the packaging states. Please keep in mind I produce no natural hormones and have been in hormone replacement therapy for 5 years, nothing has worked as well as this product. It is safe, effective, and works quickly.

Marianne F. Sanders

Reviewed in the United States on March 14, 2016

These have helped me a great deal. I am an estrogen-positive breast cancer survivor so I could no longer use prescription estrogen creams to stop my vaginal atrophy. This has helped alleviate pain wonderfully well.

Amazon Buyer

March 4, 2016

Helped my UTIs

I am a breast cancer survivor with chronic UTIs. I was told that they were caused by vaginal atrophy due to loss of estrogen, but I cannot use any estrogen due to the cancer diagnosis. I tried this product to see if it would help, and to my amazement, it did!

The atrophy was causing inflammation in my urinary tract, and the inflammation was attracting bacteria, generating an infection. I had one almost constantly for 3 years.

Literally the first time I used the product I could see and feel a difference. I have not had a UTI since starting this product. The rest of the benefits of no atrophy are great, but I am so grateful to have found this helpful product for my urinary tract. Hopefully, other sufferers will find the same result.

Neurotech

Reviewed in the United States on July 14, 2015

I have been using the Silk formula for about five months. I had post-menopausal vaginal dryness which was contributing to repeated UTI’s. The dry atmosphere promoted bacterial growth.

In addition, I had extreme vulvar pain (vulvodynia) and every remedy I tried felt as though I was applying acid. I was desperate after three rounds of antibiotics in four months and still had horrible burning pain.

My doctor prescribed hormone cream but I was reluctant to use it since there is a history of breast cancer in my family.

While desperately searching online (sitting on a cold compress at the time) I came across NeuEve and ordered immediately, both the silk formula and the cream to start with. I experienced immediate relief, using the cream daily for about the first month and the suppositories twice weekly as directed. No more UTI’s!

Immediate relief and freedom from the burning! I saw my GYN for the yearly checkup two weeks ago and he is very happy that the dryness has resolved. He thanked me for the information about NeuEve and said that he is pleased to have a safe alternative to the hormone cream to recommend to patients.

I am just about to try the Silver formula. I will never be without NeuEve! Dr. Chang is obviously very knowledgeable about this problem to have created such an effective treatment. I will be forever grateful that she did!

Amazon Customer

Surviving Radiation Therapy with NeuEve

Reviewed in the United States on May 5, 2015

“Thank you, Dr. Chang. And thank you for the greatest product ever. I had uterine cancer and underwent radiation therapy. NeuEve has been a life-changer.”

Katie M

Bicycling painful and it was making me miserable although I am ..

Reviewed in the United States on February 26, 2015

I am a young sixty-year-old woman and breast cancer survivor. My kids call me sixty and sexy, but I was not feeling sexy.

I was extremely sensitive and tender to the point that my clothes chaffed me, sitting was uncomfortable, bicycling painful and it was making me miserable although I am a happy individual.

I had used estriol cream with little effect. My woman’s health doctors dismayed that the gynecological world was focused on the reproductive years and women beyond that were ignored.

After being told I should use zinc oxide to heal the chaffing, I desperately and thankfully sought help on the internet and discovered NeuEve and Dr. Chang.

I am only using less than a week and I am the most comfortable I have been in years. I just subscribed and am thrilled to have regained my sexual health. Thank you, Dr. Chang!

Kizzikate

A Life-Changing Product!

Reviewed in the United States on October 20, 2014

Just returned from a mini-vacation with my boyfriend, had to write!

After over a year of post-menopausal dryness, painful sex, and bleeding after intercourse, I was desperate for a solution. I am uninsured, so I cannot use prescription estrogen because it is too expensive. Nothing I tried over the counter worked well, especially for the pain and bleeding.

I used one Silver suppository the night before our trip. When I got up to go to the bathroom during the night, I could literally feel it working! It is hard to describe, but it felt tingly like my tissue was plumping and coming back to life.
Well, the next night when we were on vacation was the first time in over a year, I had sex that was pain-free! We used a glycerin-based lubricant and had a wonderful night together. We were amazed! But I did experience bleeding afterward, as usual.

My boyfriend was being a good sport about the bleeding, so I used a second suppository the next morning before we started our tour. Well, that night there was no pain OR bleeding…… Nothing! I felt so liberated. No more towels or sanitary pads, I have my dignity and my sexuality back!
I am spreading the word to all my friends. Those who are great cancer survivors will be especially excited to try NeuEve! It was truly life-changing for me, and I cannot thank you enough for this wonderful product!

About the author

Dr. Renjie Chang's medical and pharmaceutical experience:
- OB-GYN in the Peking Union Hospital in China
- a faculty member of OB-GYN at University of Oklahoma Health Sciences Center
- drug developer at the Abbott Laboratories in Chicago
- Founder of Lavax, Inc, where she developed an innovative vaginal microbicide for preventing sexually transmitted disease with grants from NIH and Gates Foundation
- Founder of NeuEve, an all-natural women's health company

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