Improving Your Vulvovaginal Health

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

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 reduce their risk of cancer. Some women can take the hormone estrogen to slow down this process. However, for many women who have had cancer, estrogen may not be a safe choice.

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. They can be used several times a week for overall vaginal health and comfort. If you have just finished cancer treatment or are going through sudden menopause, you can use them more often, up to 3 to 5 times a week. You can use them at any time, not just before or during sexual activity.

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

See below for examples of moisturizers that can be applied to your vaginal and vulvar tissues.

Hydrating types

  • HYALO GYN®
    • This moisturizer can be applied both inside of your vagina and on your vulva.
    • You can buy HYALO GYN online at www.hyalogyn.com
  • Replens™ Long-Lasting Vaginal Moisturizer
    • This vaginal moisturizer can be inserted into your vagina with a disposable applicator or applied to your vulva.
    • You can buy Replens Long-Lasting Vaginal Moisturizer at your local pharmacy.

Soothing (natural oil) types

  • Carlson® Key–E® Suppositories
    • These are suppositories (solid medications that dissolve) 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

How to use vaginal and vulvar moisturizers

  • Many vaginal moisturizers come with an applicator. You will need to use a full applicator and insert carefully into your vagina. You can apply a lubricant to the tip of the applicator to make it easier to insert.
  • You can also use vaginal moisturizers on your vulvar tissues, including your inner and outer labia (the folds of skin around your vagina). To apply these moisturizers to your vulva, apply a small amount (pea or grape size) of moisturizer to your finger. Massage the moisturizer into your vaginal opening and on your labia.
  • Many people use these moisturizers 3 to 5 times per week to help relieve their symptoms.

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 be very drying to your vulva. Before using the panty liner or pad, apply the skin protectant cream to 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 and minimize discomfort. 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)
  • Luvena®
  • Yes®
  • Aquagel®
Silicone-based lubricants
  • Pjur®
  • PINK™
  • Astroglide Silicone
Natural oils
  • Almond oil
  • Coconut oil

Avoid colored, flavored, or warming lubricants. They can cause irritation.

Never use petroleum jelly (such as Vaseline®) as a lubricant. Petroleum jelly is hard to wash away and can irritate your vagina or increase your risk for vaginal infection.

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

How to use vaginal lubricants

Apply the lubricant to 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 vulvovaginal health. Vaginal estrogen is only available with a prescription, because it’s not safe for everyone.

The medications listed below are brands 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.
  • Estring®
    • This medication comes as a vaginal ring. Insert the ring into your vagina and push it as far back as possible. Remove it after 90 days.
  • Estrace®
    • This medication comes as a cream that can be applied 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. These can be purchased over the phone, online, or from a specialty store.

Below is information about specialty stores located in New York City, as well as a few websites. You can also search online for other specialty stores near you. We are not endorsing these stores or websites.

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 or concerns, contact a member of your healthcare team directly or call 212-639-2000 for help.
If you have any questions, contact a member of your healthcare team. After 5:00 pm, during the weekend, and on holidays, call 212-639-2000.

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

Improving Your Vulvovaginal Health - Generated on May 20, 2019
©2019 Memorial Sloan Kettering Cancer Center

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