• Lack of desire (libido)
• Vaginal symptoms with intercourse: pain, bleeding
• Inability to climax

Treatment of breast cancer often includes chemotherapy that causes menopause and that may be further complicated by medicines that reduce estrogen levels. Estrogen is necessary for the normal functioning of a woman’s genital tract including the vagina AND the lower part of the urinary tube (“urethra”) thru which the urine passes. The lack of estrogen makes the tissues very thin and susceptible to being torn (like a “skinned knee”) and this may cause pain and bleeding with intercourse, and make women more susceptible to urine infections.

To properly address these issues, we need

• FIRST: To check the health of the genital tract.
  • A gynecologist will check on the condition of the genital tract, that is: the outside (“exterior” or “perineum”) tissues, the vagina, the cervix, the uterus, the ovaries, and the examination of the other pelvic tissues.
  • If there is a specific problem, often correcting that may allow normal sexuality
  • However, most of the time, this is a complex issue which includes both BODY and MIND.
• SECOND: A psychologist or sexual therapist can review the mental or psychological aspects of sexuality
  • I am always reminded of a quote from (I think) Goethe. He was a charismatic and engaging man, but was apparently not very attractive. He was apparently quoted as saying, “Give me 5 minutes with a woman and she will forget my face!”
  • And another quote from a wise person whose name escapes me: “The most important sexual organ is…THE MIND!”
  • The issue of “desire” is really an issue for “behavior modification.” At the Breast Cancer Symposium in September 2010, Dr Michael L Krychman talked about “mindfulness therapy” to address this.

Dr Krychman has written a very informative book, pictured above, that I highly recommend. You can read extending excerpts from it online by clicking on Dr Krychman’s name. The title of this blog was a quote from one of his patients!

Next blog, we’ll summarize some of his recommendations about vaginal moisturizers.

  Dr Holmes

I’ve wanted to start this blog for SO LONG so I can share other thoughts with you for which there just isn’t time during our very busy check up visits. That clever quote we always share when you recount the many interruptions you have, also applies to ME: “Life is what’s happening when you are making plans!” However, for TODAY, I want to spend 5 minutes with you so we can be prepared.

Do you remember your “Ike” experience? My home was without power for 14 days during Hurricane Ike. Luckily, my husband’s office got a generator after the first week so we had air conditioning and a refrigerator. My gallant husband let me sleep on his office couch while he camped on the floor beside me (with our dogs “guarding” us nearby). We showered in the workshop area. I realized how much of my life’s daily comforts I take for granted.

As we’ve often discussed, I prefer a “belt and suspenders” approach to problems. I want to make DOUBLY sure we have our vulnerabilities covered! So, we’ve got to prepare now IN CASE we have ANOTHER IKE. There are MANY web sites where you can get lists of the items you need to store away in case we have another storm that takes away our electric power and I’ve listed them in the box below. MY CONCERN, however, is YOUR MEDICATIONS.

HURRICANE PREPAREDNESS SITES

• http://www.nhc.noaa.gov/HAW2/english/disaster_prevention.shtml
• http://www.ready.gov/america/beinformed/hurricanes.html
• http://www.bt.cdc.gov/disasters/hurricanes/

I urge you to do these things now:

Prepare a 2 week supply of each of your (and your spouse’s if needed) medications

• Put your medicines in a zip lock baggie and put it in an easily accessible (and memorable) place, (I use my underwear drawer!)
• Keep all of your medications in the proper bottle that identifies them (in case someone other than you has to retrieve them). Ask your pharmacist to prepare an empty bottle with the prescription drug label and directions on it for your Hurricane-Emergency Medication Kit
• At the end of the Hurricane Season, November 1, put these medications back into your current bottles, but REFILL your Hurricane-Emergency Medication Kit so you will always have a 2 week supply if there are any other emergencies
• On June 1, next year, recycle your medications again.

As always, if you need to evacuate for any significant period of time, take YOUR CHART with you. If you cannot fit the entire chart, then at least take your most recent Clinic Note that I have given you.

The meteorologists tell us we may have 7-12 hurricanes this year. Let’s be prepared. My goal is ALWAYS to do whatever I can to assure that your breast cancer limits your life as little as possible. If you are taking medications to treat breast cancer, I don’t want the cancer to get a free ride during a hurricane. Make your Hurricane-Emergency Medicine Kit now. ☺ Hugs, Dr Holmes