Breast cancer pushed me into menopause at just 37. I refused to let it ruin my sex life.

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One cold February day a few winters ago, I was sitting naked from the waist up on an exam table in my oncologist’s office. The doctor had just completed my quarterly breast exam and was studying my labs. I had gotten used to being poked and prodded like a tomato at the grocery store during these appointments, part of my ongoing treatment for early stage breast cancer.

In the five years since I was diagnosed, I had undergone a unilateral mastectomy and endured it targeted hormone therapy. The treatment saved my life, but it also pushed me into medically induced menopause at just 37 years old. By this visit, thankfully, my cancer was in remission and I would live to see my two young children grow out of diapers. But I dreaded those follow-up appointments, anxious that my doctor would once again find a tiny Tetris-shaped spot on my scan that would throw my life into chaos. This time she was also nervous about something else.

“The labs look good,” he said, turning in his chair to look at me as I wrapped myself in the thin hospital gown. “How are you feeling?” he asked

I took a deep breath. “Well, everything feels good here,” I said pointing to my breasts. “But,” I paused, feeling a little embarrassed. “What is it?” he asked

“I’m having a lot of trouble ‘down there,'” I said, pointing to my vagina. I felt her start to cry. “I can’t, it hurts so much during sex.”

I was filled with relief when he didn’t reprimand, but nodded. He explained it vaginal atrophy it is a very normal and common symptom of menopause. He was glad he said something because he did many women do not.

When I was first thrown into premature menopause, I felt like my body and mind had short-circuited. All hell broke loose at the cellular level. Practically overnight, I went from being a healthy, energetic mom to a mess. He couldn’t remember the plot of the TV show he had just watched or the thread of a conversation. I gained weight. My hair started falling out. While it was easy to feel uniquely cursed, it’s a more common scenario than you might think: It is estimated that 5% of women enter menopause before the age of 40 and people can be pushed into it medical menopause for a number of different reasons, including hormone therapy, chemotherapy, radiation, and surgery.

Finally, through trial and error and many sleepless nights googling, I got my postmenopausal symptoms under control. I started taking vitamins and supplements for mood swings and hot flashes, and melatonin gummies for insomnia. I tried acupuncture for muscle pain and yoga to maintain bone density. Little by little, my energy levels started to recover and I felt more like my old self. Except for one thing: I couldn’t have sex anymore.

My worst menopausal symptom, and the least mentioned symptom even in my extensive internet trawling, was vaginal atrophy, the thinning and drying of the vaginal tissues, which causes extremely painful symptoms during sex (Think: pain levels of shards of broken glass inside your vagina.) My husband and I had been through a lot together: two children, the loss of my mother to cancer, and then my own diagnosis of cancer, and he was always by my side. We had an active sex life. In the post-cancer phase of my life, I wanted to feel like a hot, hot goddess, ready to wreak havoc. Instead, I felt like I was broken. You’d think I would have called my doctor right away to see what could be done. Except…I didn’t.

I’m a mental health therapist who prides myself on being open, but it took me years to get help. Why? Because I was ashamed to admit that my body was changing. I was still young, but I felt old and dry. None of my friends had gone through menopause and my mother had died. I felt very alone. When I finally got up the courage to say something to my doctor, I was grateful to receive compassion, but many people don’t. Some of my friends who are also cancer survivors were fired after voicing their concerns. A doctor told my friend that her vaginal symptoms were caused by lack of sleep. Another doctor said, “You have to use it or you’ll lose it.” creepy

It’s appalling that this kind of misogyny still exists when the public discourse on menopause has changed radically in the last decade, thanks in part to high-profile figures speaking frankly about their experiences. A few months ago, Drew Barrymore breezed through her first perimenopause ordeal on air with Jennifer Aniston. Gayle King openly discussed through menopause CBS Mornings and referenced her “dry vagina” three times – my new hero! But while hot flashes and mood swings are now fun fodder for talk show segments, many people are still reluctant to talk about their more intimate symptoms.

Menopause and sex life at the intersection of women’s pain, pleasure, and aging, all topics that somehow still—in 2023: Make doctors (and society in general) stand together, leaving women to suffer in silence. While a reported 50 to 60 percent of postmenopausal people experience vaginal atrophy, research alone shows a quarter of them they end up seeking medical help for their symptoms. And when people do, they often find themselves with inadequate care in a terrible cycle of self-perpetuation: surprisingly, 3 out of 4 people seeking medical help because your menopausal symptoms don’t get it. Women’s health it remains chronically under-discussed, under-researched and under-funded.

To be honest, even with my own symptoms, I was in denial about what was happening to my body. Not yet 40, it devastated me to think that I might never have good pain-free sex again. At first, I ignored my pain and discomfort, hoping my symptoms would go away, but they only got worse over time. Only when I became desperate to fix my sex life did I finally seek help.

My oncologist recommended non-hormonal remedies as the first line of treatment, such as hyaluronic acid suppositories and coconut oil, but I had already tried those options and none of them gave me relief. Next, he prescribed a low-dose topical vaginal estrogen cream. I was initially concerned about using an estrogen product because my breast cancer was sensitive to hormones, but he reaffirmed that the research on breast cancer risk and topical estrogen shows that it is a safe and effective option for survivors. He talked me through all my options and most importantly listened to me. He understood that quality of life also means quality of my love life. My sex life, my family life, my married life, my hot hot goddess life, it all mattered. Not just being alive, which of course I’m lucky to be. But there’s more to it than smooth survival.

I have decided to try the estrogen cream and I hope it helps. Of course, most women don’t have access to personalized health care from multiple specialists or the time and resources to review complicated medical reports and clinical studies. Instead, they’re making important health care decisions based on Google searches, Reddit threads, and outdated research. The medical community could be doing a lot more to address the “taboo” symptoms of menopause. Wouldn’t it be great if doctors took the initiative and directly asked all postmenopausal women about their vaginal symptoms as soon as they sat down for an exam, instead of waiting for their patients to explain?

I didn’t expect my ovaries to shut down at age 37 after a nasty cancer diagnosis. It hasn’t been easy, but through it all, my husband and I have redefined what intimacy looks like for us. Having sex forced us to look at our partner in a whole new way. We started couples counseling and had difficult conversations about sex that eventually brought us closer together. It’s something we’ll probably have to do over and over again throughout our marriage. Of course, there are times when the unfairness of it all lies between our bodies, the eternal why: why me, why cancer, why my vagina? But most of the time, I feel grateful to be here, helping others forge a path, even through all those impossibles. whys.

This story was originally published on August 3, 2023.

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