Menopause After Cancer: A Search for Intimacy Beyond Treatment

A survivor navigates the complexities of vaginal atrophy and the quest for sexual well-being

A breast cancer survivor’s journey through treatment-induced menopause uncovers a stark reality: the medical field often overlooks the intimate challenges faced by women, leaving them to seek solutions in expensive, and sometimes ineffective, procedures.

The Unexpected Side Effects of Survival

Following a breast cancer diagnosis in October 2017, Anna Sullivan Reiser underwent a mastectomy, reconstruction, and a decade of hormone therapy. This treatment, designed to eliminate estrogen and reduce cancer recurrence, abruptly threw the then 37-year-old into surgical menopause. The transition was swift, leaving her with debilitating hot flashes, bone aches, and vaginal atrophy, a condition characterized by severe dryness and discomfort during intercourse.

Sitting in her doctor’s office, clad in a hospital gown, Reiser voiced her distress: “It really hurts to have sex,” I told my doctor. “Like, a lot.” Her physician, who had diagnosed her cancer, acknowledged the difficulty, noting, “I know how it feels to go through menopause. Especially since you went through it overnight.”

Exploring ‘Vaginal Rejuvenation’

The doctor suggested a then-emerging treatment: laser vaginal rejuvenation. This fractional CO2 laser therapy aims to revitalize vaginal tissues by stimulating new blood vessel growth, offering a hormone-free alternative for vaginal atrophy. However, Reiser discovered the treatment carried a significant cost, approximately $3,000 for three sessions, and was not covered by insurance. Concerns about potential risks, including excruciating pain and rare vaginal burns, were also noted.

Despite the drawbacks, the prospect of relief propelled Reiser to try the procedure. She recalls the initial visit to an Albuquerque clinic, where a receptionist’s amusement at the term “vaginal rejuvenation” highlighted the societal awkwardness surrounding women’s sexual health issues. The procedure itself involved a numbing cream and a whirring laser device, prompting a wry internal thought: You’ve come a long way, baby.

Mixed Results and a Wider Disconnect

The first laser session brought immediate, albeit temporary, relief. After the first session, I noticed something right away. My vagina seemed happier. In fact, it didn’t hurt ― at all. However, this positive change did not translate to pain-free intercourse, leaving both Reiser and her husband, Alex, frustrated.

Subsequent treatments yielded minimal improvement. Six months post-initial consultation, Reiser returned to her doctor, reflecting on the limitations of current treatments. Most women can’t afford expensive vaginal laser treatments, and instead, are learning to normalize their pain or simply avoid talking about it. she stated, emphasizing the systemic gap in women’s healthcare.

The lack of accessible and effective solutions for vaginal dryness is striking when compared to treatments for male sexual dysfunction. A 2019 study in the Journal of Sexual Medicine noted that while treatments for erectile dysfunction are widely available, options for female sexual health often remain limited and underfunded.

Redefining Intimacy and Seeking Solutions

While laser rejuvenation did not fully resolve her pain, Reiser was prescribed Lidocaine, a numbing cream, for use before intercourse. Her doctor’s parting words, welcome to menopause, we’ve come a long way, baby, were met with skepticism: But have we?

Unable to use estrogen creams due to her cancer history, Reiser and her husband began exploring non-penetrative forms of intimacy. These discussions, though initially awkward, have deepened their connection. We’ve redefined what sex and intimacy look like to us — and that feels like a success. she shared, acknowledging that true success lies in adapting and communicating.

Anna Sullivan Reiser continues to advocate for women’s health, co-hosting the podcast “Healing + Dealing” and exploring further treatment options. Her experience underscores the urgent need for better research, accessibility, and open dialogue surrounding menopause and its impact on sexual well-being.