Returning To A Normal Life After Breast Cancer – Video
The Center for Intimacy After Cancer Therapy Inc.
What about pain medications? Do they affect sexual function
Living in chronic pain can negatively affect your activities, and overall mental, physical, and emotional well-being is impacted. By controlling discomfort, you can effectively regain control of your life, enjoy a more active vibrant lifestyle, and enjoy social connections. Letting your pain get out of control often leads to feelings of anger, frustration, depression, or even isolation and stress.
Your oncology doctors, nurses, pharmacists, anesthesiologists, neurologists, and perhaps a specialist in pain management all help to manage pain. There is no reasonable rationale to suffer in silence, be stoic or brave, believe that discussing your pain or discomfort is a sign of weakness, or to even rationalize your suffering as being part of the healing process. Discuss your concerns with your healthcare team. Some patients who fail to discuss pain control mistakenly believe that if they do take prescribed pain medications they will become addicted. This is rarely the case, even if you are taking strong medications like narcotics or opioids. Some people fear the potential side effects, like constipation, nausea and vomiting, lightheadedness, feeling confused, or even a feeling of loss of control. Discuss your personal concerns with your doctor so that your dosing schedule can be modified or medications changed to minimize side effects while maximizing pain control.
There are many types of cancer pain, including acute, chronic, and breakthrough pain. Pain can come from the cancer tumor itself or be a result of the surgery, chemotherapy, or radiation therapy you have received. Phantom pain can occur at the site of an amputation or limb removal, and some women who have had mastectomies or complete breast removal can feel abnormal pain, sensations, or discomfort at the area where the breast is missing.
Sometimes cancer pain treatment will involve medications and nonmedical techniques that can minimize your pain. It may be helpful to develop and implement an adequate pain management plan with your healthcare team. Some pain medication is over the counter, and others are prescribed by your doctor. Before your medical visit, write and bring a list all of the medications you are taking. These drugs can be analyzed so that possible side effects or drug interactions can be minimized. Some of the medications typically used for pain control are listed here. This list is not exhaustive, and new medications may be offered by your doctor. Pain medications can come in the form of pills (taken by mouth), patches, and liquids (elixir), or they may be injected into your bloodstream (intravenous), muscle (intramuscular), or the space around nerve endings in your spine (epidural). Suppositories also may be used.
Magnolia Myrick said:
I’m one of those people who “hates to take things” like pain or sleep medications. And that is ridiculous. I’ve finally come to realize I want my body’s energy to heal and not to struggle with pain or insomnia. I know when I need them and when I don’t, and so will you. I think of these medicines as working with my body, and that’s what we want.
How can I control pain and still have sex?
If you are in pain, sexual activity may not be important to you. Many pain medications can change hormones and thus affect sexual appetite and interest. Discuss your pain medication selections with your provider.
Plan sexual activity when your pain is at a minimum. Let your partner know that you are in pain and would prefer to snuggle rather than have intercourse. Some sexual medicine specialists will actually advocate use of pain medications before sexual activity. Finding a comfortable sexual position may also limit pain. Sometimes stretching exercises or even guided imagery can be helpful. Try to control your level of pain with both Eastern and Western methods of pain management.
As with any surgery, one should expect pain-the amount of pain experienced is usually dependent on the extent of surgery.
Breast surgery is no different. Breast saving surgery, for example, creates less pain than a mastectomy. Mastectomy alone may create less pain than a mastectomy with reconstruction. However, every woman and her experience with are unique. Surprisingly, lymph node sampling creates the greatest amount of pain and also causes range of motion issues. Physical therapy may be helpful in some cases.
Touching and massaging may help reduce some of the painful areas and create a sense of closeness and intimacy. Gently rubbing the scar area helps to reduce formation of scar tissue. After the surgical line is healed, lotion or oil can be used. If a partner is involved, this can be seen as very loving and caring. Some of the medications taken during treatment create severe bone pain in the long bones and the small of the back. This pain also can be reduced by gently rubbing, possibly with an oil or lotion.
Neuropathy, a result of medications, is usually experienced in the hands and/or feet. Rubbing these areas helps to reduce the pain and create intimacy. Estrogen deprivation can cause the wall of the vagina to thin and make intercourse painful. This is a time for creativity so that sexual activities can be meaningful but still not include penetration.
Term:
Neuropathy – Damage to nerves of the peripheral nervous system
What are bioidentical hormones? Are they safe?
According to the American College of Obstetricians and Gynecologists committee, compounded bioidentical hormones are created, mixed, and packaged by a pharmacist who can customize the product according to the physician’s specifications. All bioidentical hormones are synthetically created. Your body makes a form of estrogen called estradiol, and bioidentical estrogen is estradiol. Estrace Cream contains bioidentical estradiol, or the same estrogen within your body, and is pharmaceutically created by Warner Chicott Pharmaceuticals.
Pharmaceutical products are tightly and strictly regulated by the governmental agencies for reliability, consistency, and purity.
Most compounded products have not undergone strict scientific study, and concerns about safety, purity, and efficacy may exist. When the compounding pharmacist mixes special hormonal blends, he or she uses bioidentical hormones. In actuality, Premarin is the one all-natural hormone. It is derived from horse urine.
Compounded products have the same risks as conventional pharmacologically produced hormones. Also, no medically recognized governing organization like the FDA officially regulates compounding substances; there is often lack of consistency, purity, and reproducibility. Thus, many women on compounded hormones complain of erratic hormonal fluctuations.
The most common compounded hormones include dehydroepiandrosterone, pregnenolone, testosterone, progesterone, estrone, estradiol, and estriol. They are administered in the following ways: oral, sublingual, implants, injectables, or suppositories. Biest consists of 20% estradiol and 80% estriol. Another, Triest, contains 10% estradiol, 10% estrone, and 80% estriol. Most insurance companies will not reimburse for these compounded products, and thus, they can be expensive for the individual. Many do not contain the same amount of concentrated active ingredients claimed on their packaging. No scientific data support the claim that bioidentical hormones are safer than conventional prescribed hormonal therapy.
Those who use compounded bioidentical hormones often advocate for salivary oral testing of hormones. Some claim that the salivary hormone results can be used to tailor an individual preparation for a woman and her unique hormonal needs. Unfortunately, there is no medical evidence that salivary hormones provide any clinically useful information. Salivary hormones depend on a multitude of factors, including the hormone tested and the time of day the test was conducted. Also, there may not be a direct correlation between salivary hormones and biologically active hormone levels, clinical state, or therapeutic results. A large variation of levels exists within the same individual and between individuals. If you are considering taking bioidentical hormones or are now taking a prescribed compound, know that it may be dangerous.
Discuss the risks of bioidentical hormones with your cancer specialist. Systemic treatment with hormones either compounded or pharmaceutically created is not the mainstay of treatment for women with hormonally sensitive tumors like breast cancer. Some providers will treat their patients with these products, but treatment remains highly controversial. Because tumor reoccurrence is possible, even if your first tumor is estrogen and progesterone receptor negative, your oncological team may not feel comfortable with hormones; however, the situation is different with minimally absorbed local vaginal estrogen products.
Term:
Bioidentical hormones – Hormonal preparations that have a similar structure to humans’ naturally occurring hormones.
