Improving Your Vulvovaginal Health

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This information will help you improve and maintain your vulvovaginal health (health of your vulva and vagina) during and after your cancer treatment.

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About Your Vulvovaginal Health

As women get older, their vagina and vulva (the skin on the outside of the vagina) become dryer and less elastic (stretchy). This process can happen sooner for women who have had cancer treatments or a surgery to lower their cancer risk. Some women can take the hormone estrogen to slow down this process. Estrogen may not be a safe choice for many women who have had cancer, however.

Below are some suggestions to help you manage vaginal and vulvar dryness and loss of elasticity. Review them with your doctor or nurse to see which ones may work best for you.

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Vaginal and Vulvar Moisturizers

Vaginal and vulvar moisturizers help to increase moisture in your vagina and vulva and improve tissue quality. These products are different from lubricants, which are used during sexual activity. Vaginal and vulvar moisturizers can be used at any time, not just before or during sexual activity. You should use vaginal and vulvar moisturizers several times a week for overall vaginal health and comfort.

Over-the-counter vaginal and vulvar moisturizers are non-hormonal. You can buy them online or at your local pharmacy without a prescription.

The following are examples of vaginal and vulvar moisturizers:

Hydrating types

  • Hyaluronic Acid Products
    • HYALO GYN®
      • This moisturizer can be inserted into your vagina with a disposable applicator (applicator that can be thrown away), put on your vulva, or both.
      • You can buy HYALO GYN online at www.hyalogyn.com.
    • Revaree
      • This moisturizer is a suppository (a solid medication that dissolves when put in your body). It should be inserted into your vagina.
      • You can buy Revaree online at www.hellobonafide.com.
  • Replens™ Long-Lasting Vaginal Moisturizer
    • This vaginal moisturizer can be inserted into your vagina with a disposable applicator, put on your vulva, or both.
    • You can buy Replens Long-Lasting Vaginal Moisturizer at your local pharmacy.

Soothing (natural oil) types

  • Carlson® Key–E® Suppositories
    • These are suppositories that you insert into your vagina with a disposable applicator. They work best if you use them at bedtime.
    • You can buy Carlson Key-E suppositories online at www.carlsonlabs.com
  • Natural oils, such as vitamin E or coconut oil
    • These can be used inside or outside of your vagina.
    • You can buy natural oils online, or at a local retail pharmacy or health foods store.

Talk with your doctor about which type of moisturizer is best for you. If you have serious dryness and irritation, a hydrating moisturizer might be better for you.

 

How to use vaginal and vulvar moisturizers

  • Many vaginal moisturizers come with an applicator. You will need fill the applicator with the moisturizer and then insert it carefully into your vagina. You can put lubricant on the tip of the applicator to make it easier to insert into your vagina.
  • You can also use vaginal moisturizers on your vulvar tissues, including your inner and outer labia (the folds of skin around your vagina). To put these moisturizers on your vulva, put a small amount (pea or grape size) of moisturizer on your finger. Then, massage the moisturizer into your vaginal opening and onto your labia.
  • If you recently finished cancer treatment, or are going through sudden menopause, you may need to use the moisturizers 3 to 5 times a week to relieve your symptoms.
  • Vaginal and vulvar moisturizers should be used before you go to bed, so the product can be fully absorbed.

If you also use vaginal estrogen, don’t use it on the same nights you use these moisturizers. For more information about vaginal estrogen, read the “Vaginal Estrogen” section below.

If you wear panty liners or pads while you’re using these moisturizers or for urinary incontinence (leaking urine), you may want to use a skin protectant cream such as Aquaphor®, Balmex®, or Desitin®. Panty liners and pads can make your vulva dry. Before using the panty liner or pad, put the skin protectant cream on your vulva to help seal in moisture and protect your skin.

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Vaginal Lubricants

Vaginal lubricants are used to add to your natural lubrication during sexual activity and help you feel more comfortable. Lubricants make sexual intercourse or sexual touch more comfortable and pleasurable. Vaginal lubricants usually come in a liquid or gel form.

 

Examples of vaginal lubricants include:

Water-based lubricants
  • Astroglide®
  • K-Y Jelly®
  • Good Clean Love® (organic)
  • Aloe Cadabra®
  • Luvena®
  • Yes®
  • Aquagel®
  • Sliquid®
Silicone-based lubricants
  • Pjur®
  • PINK™
  • Astroglide® Silicone
  • Uberlube
Natural oils
  • Almond oil
  • Coconut oil

Semen, saliva (spit), and some lubricant ingredients (such as chlorhexidine, glycerin, and propylene glycol) can be irritating for some people. Avoid colored, flavored, or warming lubricants because they can be irritating. Never use petroleum jelly (such as Vaseline®) as a lubricant. Petroleum jelly is hard to wash off and it can irritate your vagina or increase your risk for vaginal infection.

If you’re using a latex condom, always use a water or silicone-based lubricant. Don’t use an oil-based lubricant, because they can break down latex condoms.

How to use vaginal lubricants

Put the lubricant on the opening of your vagina and on whatever is being placed in or near your vagina, such as an applicator, dilator, finger, object, or your partner’s penis, before it enters your vagina.

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Vaginal Estrogen

Vaginal estrogen is a hormone medication that can be used to maintain your vulvovaginal health. Vaginal estrogen is only available with a prescription, because it’s not safe for everyone.

The medications listed below are different brands and dosages of estradiol, a type of vaginal estrogen. Be sure to talk with your doctor or surgeon before using them.

  • Yuvafem (Vagifem®)
    • This medication comes in an applicator. Insert it into your vagina every day at bedtime for 14 days. After 14 days, insert it into your vagina twice a week at bedtime.
  • Imvexxy®
    • This medication comes in an oil-based vaginal suppository. Insert it into your vagina every day at bedtime for 14 days. After 14 days, insert it into your vagina twice a week at bedtime.
  • Estring®
    • This medication comes as a vaginal ring. Insert the ring into your vagina and push it as far back as possible. It needs to be removed and replaced every 90 days.
  • Estrace®
    • This medication comes as a cream that can be put inside your vagina and around your vaginal opening. Your doctor or nurse will teach you the best way to apply it.
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Enhancing Sexuality

There are many products available for enhancing sexuality, such as lubricants, lingerie, and sex toys. You can buy these online, from a specialty store, or over the phone.

The following is a list of specialty stores located in New York City, as well as a few websites. You can also search online for other specialty stores near you. Memorial Sloan Kettering (MSK) doesn’t endorse any of these companies.

 

New York City specialty stores

Websites

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Female Sexual Medicine & Women’s Health Program

If you would like more support or information about sexual health and intimacy, talk with your healthcare provider about Memorial Sloan Kettering’s (MSK) Female Sexual Medicine & Women’s Health Program. You can also call 646-888-5076 for more information or to make an appointment.

The Female Sexual Medicine & Women’s Health Program provides services at the following locations:

  • Evelyn H. Lauder Breast Center
    300 East 66th Street (between First and Second Avenues)
  • Rockefeller Outpatient Pavilion
    160 East 53rd Street (between Lexington and Third Avenues)
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If you have any questions, contact a member of your healthcare team directly. If you're a patient at MSK and you need to reach a provider after 5:00 pm, during the weekend, or on a holiday, call 212-639-2000.
If you have any questions, contact a member of your healthcare team directly. If you're a patient at MSK and you need to reach a provider after 5:00 pm, during the weekend, or on a holiday, call 212-639-2000.

For more resources, visit www.mskcc.org/pe to search our virtual library.

Improving Your Vulvovaginal Health - Last updated on October 18, 2019
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