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Awkward Auntie Question No. 8

Dr. Anne Katz

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Q: I’ve recently become sexually active again (I’m 2 years post-treatment) and have been experiencing bleeding during/post-sex. I use lubricant, but I’m wondering if this is a problem for anyone else? I’m going to make an appointment with my gyno, but I’m just concerned. Last time I went in, I was told I wasn’t menopausal yet (though my AMH levels were a bit low). I’m only 23 and this has been very frustrating. The bleeding is spotting because it’s not continuous but it’s initially more than I would typically expect and sometimes continues to spot for a while after. And sometimes there’s pain but not sharp pain, just like soreness?

Awkward Auntie: Firstly, you need to see a GYN and preferably one who has experience with cancer survivors. There could be any number of reasons for the bleeding during and after sex; small tears could be occurring due to friction during penetration and this is causing the spotting and pain. Because you had a stem cell transplant you may have some changes due to graft vs. host disease (GVH) – this is why I am suggesting that you see a GYN who knows about cancer as a ‘regular’ GYN may not recognize the GVH. It’s also possible that lack of estrogen may be causing the vaginal tissue to be easily torn. You did not state whether you are still getting periods etc and we often see early signs of menopause (scary at your age I know) in young women who have undergone stem cell transplantation due to the effects of the conditioning regimen on the ovaries.

Secondly, not all lubricants are created equally – and you may need a more ‘cushiony’ type. Water-based lubricants can dry out quite quickly and a silicone based lube may be better for you. I would try one of these and see if you like it and if it works better. But a visit to a GYN is essential!

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.