Women’s Sexual Health After Transplant
Women’s Sexual Health After Transplant – Celebrating a Second Chance at Life Survivorship Symposium
Nearly half of people after hematopoietic stem cell transplant (HSCT) experience sexual dysfunction! And for women, sexual dysfunction does not get better over time… unless it’s treated!
The most common sexual health concerns after HSCT include:
– Low sexual desire
– Sexual pain
These sexual health concerns are more likely to happen if you:
– Are/have been on chemotherapy
– Have had total body irradiation (TBI)
– Are on a variety of medications
– Are experiencing psychosocial distress
What can you do if you’re experiencing these sexual health symptoms?
Low desire
Tap into receptive desire: Receptive desire is a type of desire where you are sexually neutral at first, sex is not on your mind, but the ingredients are in place that allow you to be receptive. Perhaps those ingredients are that you have energy, you’re not in pain, you feel relaxed. Then, your partner initiates and you think, “hmm. . . sex wasn’t on my mind, but I’ll be receptive.” Or, if you don’t have a partner, maybe you pull out an erotic novel, or put something sexy on TV– and you think, “hmm. . . I wasn’t thinking about sex, but all the right ingredients are in place, so yes, I’m receptive to have solo sex.”
Bottom line, if your spontaneous desire has been impacted by HSCT treatment, then explore your receptive desire. They key is to identify what ingredients need to be in place to be receptive, and then set aside time to get those ingredients in place. Think about these ingredients and share them with your partner, so they know when you’re more likely to be receptive. Or, if you don’t have a partner, set aside time to cultivate these ingredients for solo sex.
Sensate focus exercises, which are sensual touching exercises, are a great way to explore how to tap into receptive desire and an excellent solution to start touching again if you and your partner have been avoiding touch.
Painful Sex
Expanding your sexual menu: Painful sex is often experienced with vaginal penetration, due to surgical or medication-induced menopause or genital graft versus host disease. If vaginal penetration causes pain, STOP engaging in vaginal sex. The more you experience pain with sex, over time you will start to pair sex and pain. When you think about sex, you’ll immediately think about pain. Over time, you start to avoid sex. It’s incredibly important to expand your sexual menu beyond penetration. One easy way to expand your sexual menu is to start with sensate focus exercises. Then get a little more advanced with a sexual menu.
If you’re experiencing vaginal dryness, you’re going to need to accessorize. You absolutely need to be using a lubricant. Water based lubricant is a great option. Put it on yourself and on your partner, you really can’t use too much. I recommend lubricants by Sliquid https://sliquid.com/ or Ah!Yes https://www.ahyes.org/.
You will also need a vaginal moisturizer. A moisturizer is different than a lubricant. A lubricant is as needed for friction reduction in the moment of sex, whereas a moisturizer is something you use daily or every other day to maintain moisture in the vulva/vagina. Think of it as face cream for your vagina. Just like how you may wake up and put on your face cream every day, this is maintenance for your vulva/vagina. I recommend HyaloGyn https://hyalogyn.com/.
If these don’t alleviate the vulvar/vaginal dryness or sexual discomfort, then you may want to talk to your oncologist about vaginal estrogen. It comes in a cream, a ring or a tablet, and can be applied directly to the vulva and vagina to feed those starving estrogen receptors. It’s the most effective treatment to reverse the sexual side effects caused by lack of estrogen. If your pain is caused by genital GVHD, talk to your doctor about treatment options, which include topical corticosteroids, prophylactic dilator use two times per week to avoid vaginal stenosis, and routine gynecological exams.
