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Breast Cancer and Vaginal Health

Posted at 1:19 PM, Jan 28, 2016
and last updated 2016-01-28 16:19:55-05

Let’s face it: At some point, if we’re lucky to live long enough, all women reach a certain age when we experience the “joys” of menopause.  Sure, it’s great to no longer have menstrual cycles or worry about pregnancy, but other effects of menopause are not so wonderful, such as hot flashes, night sweats, loss of sex drive, issues with pain and dryness, urinary incontinence and more.  For most of us, menopause occurs in our early 50s, and signifies the decreasing production of estrogen from our ovaries. Many women choose to take hormone replacement therapy (HRT) to alleviate these symptoms.

But for some women, especially those with premenopausal breast or other reproductive cancers, menopause comes early and it doesn’t come easy. The majority of breast cancers (80 percent) are sensitive to estrogen, and so part of the treatment to lower the risk of recurrence is to remove any estrogen in the body that might inadvertently stimulate the cancer to come back. Doctors can accomplish this by prescribing anti-estrogen medications such as Tamoxifen or by recommending surgical removal of the ovaries. These techniques work really well to improve survival from breast cancer, but at a price. In addition, many chemotherapy treatments can affect the ovaries, suppressing estrogen production. Sometimes this effect is temporary, but often the ovaries are permanently, prematurely shut down, resulting in early menopause.  This is a significant issue in Nevada, where breast cancer is the most commonly diagnosed cancer among women, according to the Nevada Cancer Coalition.

When menopause is induced earlier than normal, the effects can be harder to accommodate without the slow decline in ovarian function that occurs with a natural menopause. Nearly 30 percent of all breast cancers occur in premenopausal women. Other causes of early menopause include removal of the ovaries due to severe endometriosis, or reproductive cancers such as uterine or ovarian cancer.

HRT may not be an option for all of these women, because the hormones could stimulate the return of their cancer or their endometriosis. So many women have suffered with vaginal changes that can permanently alter their daily lives, sometimes even damaging their most important intimate relationships.  

But the scope of the problem is really much larger, because women who are diagnosed with breast cancer after menopause also suffer the same changes, again without the option of taking HRT. In addition, many women in menopause, even those without cancer, still can’t take HRT due to other medical issues, such as risk of blood clots or migraines.

Doctors can prescribe the use of lubricants to help with menopause-related issues, but they won’t help address all of a woman's symptoms. A new technology has recently become available, however, that uses laser energy to regenerate the vaginal lining, helping to relieve these symptoms.  Called Femilift, the treatment utilizes a CO2 laser to stimulate new collagen and blood vessel production in the vagina, resulting in a tightening, toning effect with improved lubrication.  The treatment involves a 5-minute office procedure without the need for anesthesia.  Three treatments, spaced four weeks apart, can provide effective results for up to a year.  Research studies with this technology also show it benefits women with tissue tearing and stretching from childbirth and mild to moderate urinary incontinence.

My practice is always happy to answer questions about women's health issues and available treatment. For more information, visit http://www.drlynnkowalski.com, or call 702-739-6467.

Article submitted by Dr. Lynn D. Kowalski