Issue link: http://viewer.e-digitaleditions.com/i/85232
I started to experience really horrible symptoms that I wasn't expecting... It was also really bad timing, as our plans and hopes of resuming a normal sex life became impossible with all those symptoms. world of chemotherapy – hard to explain unless you have actually been there – but if you are anything like me you have an inert need to know exactly what is in every drug capsule and intravenous cocktail and the likely side-effects. quiet. All the worse then when, seemingly out of I resisted hard looking up things on Google but sheer control-freakism overruled me and I looked up everything about chemo, steroids, loss of hair, Herceptin and what I could expect over the coming months. Nightmare, but I had to do it. Knowing as much as I could about the treatment meant that I retained some control over my life, and meant that I could do something other than just lie there and take it. Radiology followed, wonderful people, easy process at the end of a long journey. After completing the course of Herceptin I thought that must be it, surely? No, Tamoxifen was going to be the thing that would help my longevity. I was given a prescription and then discharged from Oncology. Back into the 'normal' world, just a pill every morning – wow, how easy is that?! I was told that I might have early onset menopause with symptoms such as loss of libido, brittle bones, hot flushes and facial hair but, by that time, these all seemed very minor and certainly nothing to complain about. After all, I was lucky to be alive. Throughout the whole treatment journey, a fulfilling sex life became completely unimportant whilst my amazingly supportive husband and I concentrated on us both getting through the situation we had suddenly found ourselves in. But as normal life resumes, your hair grows back and your steroidal weight-gain subsides, you do start to feel (and look!) like a woman again. By this time, medical support has been relinquished; you are out of the system and not in need of treatment anymore. Wrong! For me, this is when the emotional juggernaut came racing out of nowhere and all the bravado, courage, cheeriness and strength built up like a fortress to 'get through' came crashing down. Friends and family have moved on and believe you have too, but I found that this was when I needed emotional support most – once the battle had been fought and the battlefield was the blue, I started to experience really horrible symptoms that I wasn't expecting: heavy vaginal discharge, awful dryness and severe itchiness all leading to painful intercourse. This was a worry, not least because I had no idea what was causing it. It was also really bad timing, as our plans and hopes of resuming a normal sex life became impossible with all those symptoms. Fortunately my GP, who was also in the dark about what to do, referred me to a sexual health specialist who said, much to my relief, "these are all common symptoms of skin atrophy due to hormonal changes from the Tamoxifen". At last I knew what was happening to me, that it was not unusual but an expected normal side-effect. My sexual health specialist (also an angel from above) knew some excellent therapies, creams and potions to help my symptoms and to help me get back on the sexual wagon. I feel confident that I can manage my symptoms with her help and, best of all, I have someone I can talk to about things 'down there'. Although my husband is wonderful, there are some things I like to keep sacred from him! It would have been great to have known about these side- effects in advance and how to minimise them. Much is written about early menopause but I found nothing about the fact that hormone suppressants such as Tamoxifen lead to skin atrophy (thinning) which makes the skin more prone to moisture-loss and infections. In my experience, there is amazing help and support available for women having treatment for breast cancer, if you know what to ask, when and to whom, and if you are in the right frame of mind to listen and retain. For me, my greatest hour of need was a psychological one, months after treatment had finished, when I was keen to get back to normal living. The unexpected issue of Tamoxifen side-effects did not help my healing process. Now however, with help from my sexual health specialist, I feel I can confidently look to the future and to another whole new brighter world. (FROM JANE MORGAN, SEXUAL HEALTH SPECIALIST, WAIKATO HOSPITAL) DRY, THIN SKIN 'DOWN THERE' TOP TIPS FOR • Wear cotton underwear and avoid • Switch to hypoallergenic versions tight-fitting clothes that rub your skin. Try to avoid using panty liners. of products like toilet paper and laundry detergent, that have no or limited perfume or colourings known to cause skin irritation. • Wash with a non-soap/soap • • substitute, such as Aqueous cream, or with just warm water. After washing, allow your skin to air- dry or pat lightly – avoid rubbing. Moisturise twice a day with a cream for sensitive skin, such as cetamacrogol. Use petroleum jelly if the skin feels really dry. • • Use LOTS of lubricant for intercourse. Non-scented oil (whatever you have in the kitchen!) is best. Dry skin often stings with water- based lubricants such as KY jelly. However, you'll need to use water- based lubricants, not oil, if you're using condoms: try different products until you find one that suits you. • • A long-acting vaginal moisturiser, Some drugs, including hay-fever such as Replens™, may help. www. replens.co.nz tablets and antidepressants, cause skin dryness: ask your doctor if any of your other tablets could be contributing. • Topical oestrogen helps but is not usually prescribed to women with oestrogen-dependent cancers such as breast cancer. • Don't put up with painful sex: ask your doctor to refer you to someone who can help such as a gynaecologist or sexual health specialist.