News & stories Ovacome Blog Returning to sex and intimacy after treatment From the Ovacome Magazine Summer 2019 . Returning to a fulfilling sex-life after treatment for ovarian cancer can be a slow process. But former nurse Sam Evans, who advises women on sexual health and is co-founder of a sex toy company, gave members some helpful tips at Ovacome’s Health and Wellbeing Day. There was much amusement among the women who attended our Wellbeing Day talk on the role of sex toys after ovarian cancer treatment, when the demonstrator vibrator sprung into life and, in uninitiated hands, could not be turned off. It is a common reaction of course, says former nurse and sexual health expert Sam Evans who gave the presentation. Sex toys after all are meant to be fun. But what many women do not realise is that they also have a more serious part to play in women’s sexual health, particularly after gynae cancer. For ovarian cancer treatment can make the vagina shorter – in the case of a radical hysterectomy – or uncomfortably tight or dry, and surgery can leave scar tissue. These are all factors which can cause women to be afraid of penetrative sex. And the longer that such problems are left unchecked a ‘use it or lose it’ situation can kick in and exacerbate symptoms. So says Sam, a director of online business Jo Divine, who advises women post treatment to ease back into their sex lives by using a mini-sized bullet vibrator for external clitoral stimulation and when a woman has decreased sensation. Also as a first step back into sex, a slim vibrator – which can be used externally and internally alongside a dilator – can help expand the vagina and massage uncomfortable scar tissue. “The vagina is a muscle that needs to keep exercising even if a woman is not having sex because it is painful, or they don’t have a partner.” “The main thing I hear from women after treatment is that they are really scared about having sex again. But a slim vibrator is unthreatening. It can help promote healing of scar tissue by increasing the blood supply to the area. And gentle manipulation massaging the scar tissue can help to stretch the tissue too to make the vagina feel less tight”, says Sam. . Keeping it safe with lubricants Lubricants are helpful for sexual intercourse, used with vaginal dilators, sex toys, or simply for clitoral pleasure if penetrative sex is painful, says Lavinia Winch, ambassador for the YES brand, who herself has had endometrial cancer. But it is important, she says, to use natural perfume-free products and avoid those which contain glycerine or glycols which can be an irritant and cause of thrush. Lubes should be pH balanced to the vagina at level 4 to 4.5, which is fairly acidic, to help prevent bacterial and fungal infections. Most women who have had cancer will want to avoid products containing paraben preservatives, Lavinia says, as although there is no proof that they cause cancer, they are hormone mimics and can disrupt hormone production. Using a water-based lubricant on top of an oil one can be particularly beneficial after cancer treatment, providing a double-glide effect. But if a woman wants to be discreet, she can solely use a water-based product without her partner knowing. To help with rehydrating scar damaged or dry vaginas an intimate moisturiser can be used by women who suffer from vaginal atrophy on the day in-between using oestrogen pessaries or cream. Using a vibrator can also help promote the production of vaginal secretions, lubricating the area and helping it feel more comfortable, says Sam. It can also be less harsh than using the NHS prescribed dilators which are made from hard plastic, whereas the vibrator can be made from body safe silicone. After treatment women can experience loss of sensation during sex and a vibrator can help here too, says Sam. “The gentle vibrations can stimulate the numerous nerve endings in the clitoris and vagina, creating waves of pleasure,” she explains. “After treatment, women can be tired, they can have a low or non-existent libido and when they do have intercourse it can be painful, the sensation is dulled and they struggle to orgasm. A vibrator can help with all of this,” she says. Silicone is the best material for an everyday vibrator to be made from, says Sam. It can be cleaned with soap and water, doing away with the risk of bacterial infections. “Products that are made from jelly and rubber will degrade,” she says, and those made from latex can cause allergic reactions. Sam also advises that women use a lubricant - the single most effective way she says of improving sex lives, but also beneficial in speeding up the healing process by nourishing scar tissue. Here too though there are certain types to avoid. Post treatment is a good time to shake things up in the bedroom. What worked pre-cancer might not now, says Sam. “Think of positions where you are more in control of the depth of penetration and which won’t catch on any scarring problem areas. Try something else and be open-minded.” Take little steps. “Don’t think that you have to go all guns blazing into penetrative sex. You can have a great sex life by kissing, cuddling, massaging or prolonged foreplay which can be as satisfying as penetrative sex. An intimate relationship is about good communication, talking, going for lunch and making time for one another.” “But if you want to get back to being your normal sexy self we have tried to identify sex toys which you won’t be scared of using,” says Sam, and of course, like the women in her talk found, to have a bit of fun with too. . Visit www.jodivine.com to learn more.