Vaginal changes

Oestrogen plays an important role in vaginal health. Taking hormone blocking treatments can lead to vaginal dryness and tightness, and this may make sexual intercourse uncomfortable or painful.

Don't be embarrassed to talk to your treating team about any side effects you are experiencing. These side effects are common and your team is used to looking after women who are experiencing these problems. They will be able to recommend many things to try.

Whatever you are thinking about trying, BCNA’s Online Network has a private group for discussing vaginal dryness and sexual wellbeing. New members are welcome.

What to try for vaginal changes

Some women find that a non-hormonal vaginal moisturiser can provide relief from vaginal dryness, itching and irritation. Products such as Replens are available from pharmacies and can provide relief for 2 to 3 days per application.

If you are experiencing vaginal dryness, sex can be painful. Vaginal lubricants used in sexual foreplay or immediately before and during sex can reduce pain and discomfort from dryness. 

Suitable and safe lubricants include Astroglide, YES and Pjur. Natural olive oil-based lubricants such as Olive & Bee can be helpful. You can use these with condoms.

Vaginal oestrogens are the most effective treatment for vaginal dryness and thinning of vaginal walls ('atrophy'). However, doctors are cautious about prescribing vaginal oestrogens for women who have had breast cancer. These creams or vaginal tablets ('pessaries') contain low doses of oestrogen that your body will absorb. Studies have shown these are safe to give; there is no evidence that vaginal oestrogens increase the risk of breast cancer recurrence. They are often given after all other methods have failed (such as vaginal moisturisers) and should be prescribed after a discussion with your oncologist.

Some cosmetic surgery centres offer laser resurfacing of the vagina to improve dryness. This involves laser applications to the vaginal lining. Trials have failed to demonstrate any significant benefit of this treatment.

What to avoid

• avoid petroleum lubricants such as Vaseline. They can interfere with the vagina’s natural secretions and make dryness worse.
• do not use petroleum-based lubricants with condoms, as they may make condoms less effective.

What to try for vaginal tightness ('vaginismus')

Vaginismus is involuntary tensing or spasms of the vagina, which can lead to vaginal tightness. This may lead to painful intercourse. 

Using a vaginal moisturiser and lubricant during intercourse can help. 

You can also purchase a vaginal dilator, which can help to slowly stretch the vaginal canal.

It is important to try and relax when being sexually intimate, because the more tense you are, the worse the situation can become. 

Sometimes a physiotherapist who specialises in in pelvic or gynaecological health can also help. Find a physiotherapist at Australian Physiotherapy Association.