Welcome to OBGYN Champs, the show where no question is off limits. Join host Morgan Allen and board-certified OB/GYN Dr. Suny Caminero, MD, as they tackle the topics women are often too embarrassed, afraid, or unsure to ask about. From hormones, menopause, and sexual wellness to pregnancy, pelvic health, cosmetic gynecology, and everything in between, each episode delivers honest conversations, expert advice, and practical insights to help women take control of their health with confidence.
Whether you’re in your 20s, navigating motherhood, approaching menopause, or simply looking for trustworthy answers, OBGYN Champs is your place for real talk, myth-busting, and empowering education. Tune in, ask your questions, and join the conversation because your health deserves to be talked about.
Dr. Suny Caminero, MD, OB/GYN
Founder of Cosmetic Gynecology Florida
Website Address: https://cosmeticgynecologyfl.com/
How can breast cancer treatment affect a woman’s vagina and sex life?
Dr. Suny Caminero:
So I’m glad that we’re talking about this today because it’s his breast cancer month. October breast cancer month. So this is a really, really. Yes, I’m thinking today. And and it’s such an important topic because so many women are fortunately are diagnosed with breast cancer and they don’t really know what happens. And the good thing is that so many women are also surviving breast cancer.
So the technology and medicine has gotten to the point now that there’s a lot that we have many, many breast cancer survivors. And then what happens after you survive breast cancer. Right. And that’s the thing that most people don’t really talk about. And sometimes it is okay. You survive breast cancer. You should just be happy that you survive breast cancer. And there’s nothing else we can do for you. And there’s a lot of things that can happen after after treatment from breast cancer and also after the preventive treatments that happen from breast cancer, for example, when women have breast cancer, depending on the type of cancer they can have, the mastectomy, they can have chemotherapy, they can have radiation.
And then after that they can also have medicines to block their estrogen, particularly if their cancer was estrogen receptor positive. And blocking their estrogen comes with a lot of different things that occur in the pelvic floor, the vagina, and really in their entire body. So I’m really happy that we’re talking about this today, because the pelvic floor does change after treatment from breast cancer, particularly if there’s no estrogen. We’ve talked a lot about lack of hormone and menopause and perimenopause. Well with breast cancer patients it’s almost it’s it’s it’s almost like a surgical menopause meaning it’s almost like a castration of the ovary.
Like it’s completely that estrogen is blocked and now you’re menopause. You’re not transitioning into it slowly. You just hit hit on it. And over time you have everything that comes with that the vaginal dryness, the painful sex, the lack of sensation, the urinary urgency, urinary incontinence, the having like zero libido, having zero sex drive. Not really interested. Your skin changes, your muscles don’t respond when your exercise, your bone changes, hair loss. Just just a number of things that happen for breast cancer survivors. And and I’m glad they were talking about it today because I want to women to know that there are so many options that we can do that are not necessarily giving you hormones to help you with all of that. So it isn’t it isn’t where okay, I survive breast cancer and this is the consequences. And I just have to deal with it. And you really don’t have to.
Morgan Allen:
Wow. So that is crazy how it puts you in a menopause overnight. That would be really challenging for anyone.
So what are some of those things that you can do to help alleviate those symptoms that come from that immediate menopause?
Dr. Suny Caminero:
So first is making sure that that your optimal meaning that your vitamin D is optimal, that your vitamins, your minerals and your body’s optimal, that you’re eating really healthy, that you’re avoiding all toxins, that you’re exercising, right, that you’re exercising, that you’re doing muscle building exercises to help your muscles. So first, kind of lifestyle changes, which many women are doing already at the ones they they’re even before sometimes they’re diagnosed with breast cancer.
So doing that first and then doing things like for your pelvic floor, for example, not necessarily people exercises because none of us know how to do them. Right. It’s just and sometimes your muscles are just not strong enough to do them. Really. They’re just weak muscles at the time. So doing physical therapy, pelvic floor exercises, we have also different things that we can do to help you with the pelvic floor exercises.
When it comes to vaginal dryness, there’s so many things that we can do, including anything. I always say a wet vagina is better than a dry vagina. Meaning that if we put hyaluronic acid in the vagina, that helps if we use the CO2 laser helps immensely with the vagina and the bladder. If we do, sometimes some women do qualify for doing vaginal estrogen, even if they have had a estrogen receptor positive breast cancer, and that for women that qualify for that, that’s really a fantastic for the for the pelvic floor.
So there are so many things and sometimes women tell me, how come I wasn’t told that there are these options okay, available for me? And part of it is because when you’re when you’re dealing with trying to survive, let’s get you survive and then. Okay, now we’ve got you to survive. And there’s, there isn’t like a track to kind of get you better after that. There isn’t that track. But and so that’s, that’s one thing.
The other thing too is that when you are in a practice that is mostly an insurance based practice, there are a lot of things that unless insurance covers, then then a physician may not know even exist. And so that’s part of the beauty of having a practice that it is a concierge practice. Because we can have we have so many options that that are not necessarily told to women are available to women in the normal traditional medical model.
Morgan Allen:
Wow. And so we hear about that pelvic floor therapy after childbirth. But so I was going to ask,
How can it help women recovering from breast cancer?
Morgan Allen:
And you mentioned that incontinence and things like that. But what are some other ways?
Dr. Suny Caminero:
So it’s really more prevention. Right. So, if the particular person didn’t have any of the issues to begin with, then afterwards to keep that pelvic floor strong and keeping the vagina not dry would help prevent really any of those things from happening. When those happen, that’s then when you start to use other therapies to to help to reverse it. At the end of the day, nobody wants to have urinary incontinence. Nobody wants to have painful sex. Nobody wants to have dry sex like you want to have a normal sexual life.
Morgan Allen: So with everything that a woman goes through with breast cancer, building that confidence again, feeling comfortable in her body again is so important and to try to navigate that while having all of these menopause hormones happening, it can really be a lot for women. So it’s amazing to know that you have tools and resources to help kind of put the body back together again. and so we mentioned the hormones a little bit.
How can hormone replacement therapy, or what is it that really helps?
Dr. Suny Caminero:
For many women who have breast cancer and have estrogen or progesterone receptor breast cancer, they don’t they don’t necessarily qualify for being on hormone therapy. Qualify doesn’t necessarily mean you can’t have it. But but you don’t necessarily qualify for it because the the hormone is what then allows the the cancer to grow. Did the hormone cause the cancer? No. Your own personal hormones do not cause cancer.
There’s a reason that cancers come from different things, but the breast has receptors for estrogen and progesterone when you place in the body has receptors for progesterone. So if you give it, it’s almost like you’re feeding the fire. And so for those women, having a hormone therapy, it really it’s not it could potentially, reactivate cancer cells that that you have deactivated or that have been dormant, for example.
And so for many of those women are on estrogen blockers to prevent that from happening. So for it is not necessarily something that we do to give women hormone therapy when they are breast cancer survivors of estrogen progesterone receptor breast cancers. But they are they are many other things that we can do to help them.
Morgan Allen:
That is crazy. I can know that. So it’s like you have this issue and you have something that will solve it, but that will also make it worse. So that is exactly yes. Really rough.
Dr. Suny Caminero:
The nice thing about the vagina is that, for many women actually do qualify for estrogen in the vagina, even if they’re breast cancer survivors. Because the vagina is. I called her, I call her, she’s greedy about estrogen. And so when you put estrogen in the vagina, it just kind of soaks it into the walls, and it leaves very little that travels into your system to really cause any issues when it comes to breast cancer cells.
So as vaginal estrogen for some women is very, very important. And it doesn’t necessarily mean that because you have breast cancer that you can’t have estrogen. You just really should not or don’t qualify for having systemic estrogen, like a pill or a patch or transdermal cream or a gel.
Morgan Allen:
Interesting.
Let’s talk a little bit more about that painful sex part of things because we mentioned the vaginal dryness. Is that the only reason people could have painful sex?
Dr. Suny Caminero:
Well painful cells can also be because of the pelvic floor. When you don’t have estrogen, there’s an inflammatory response to to the public floor. So those muscles can be very tight. It’s like hypertonic muscle. They’re just like really contracting and tight.
So not only do you have the dryness and then the dryness the thinness of the tissue, then the nerves themselves actually retract back. So now you have less pleasurable sensation but more painful sensation. And then the muscles are like clamped like contract, like a, like a Charley horse. And so all of that combined is just for some women. Like we just can’t we just can’t do it. It just can’t happen.
Morgan Allen:
Yeah. Because when your body isn’t relaxed, makes it very hard for anything to go in and out of it.
Dr. Suny Caminero:
And also when you’re in pain. Right. So when you’re in pain, you’re immediately if there’s an area that you have pain, if somebody comes close to that area, even if it’s on your arm, you’re like, you immediately retract, right? Like you are aware that this area hurts and don’t come close.
Same thing for the vagina. You’re aware that that’s going to feel like charred glass. You’re going to you’re just going to retract. No matter how much you’re trying, no matter how much you try to relax, how much you’re like, okay, we’re going to and many women do this.
They’re like, I have to do this for my husband. And so they’re just like, they try really, really hard. They relax really hard. And it’s just that that it hits right at the entry point even before it goes all the way in. And it’s just too painful.
So you mentioned the C02 laser. That will fix the dryness, right?
Dr. Suny Caminero:
Not only does it fix the dryness, it also fixes the thing the thickness of the vagina. It makes it thicker because it stimulates collagen production to the vaginal tissue. The thicker that that tissue is, the more lubrication comes to that area. And then that in combination with something like hyaluronic acid. And to keep that moisture there, it works really, really well.
Morgan Allen:
Like those two combined would be like the fix would be very well.
Dr. Suny Caminero:
Yeah, yeah. And pelvic floor therapy. Sometimes we use the chair to, to get those muscles. It’s, it really is a fantastic chair. Actually not everybody qualifies depending on how your muscles are, whether it’s hypertonic or relaxed, but it’s a magnet.
You sit on this chair and then it gives you this energy to your floor and you get, believe it or not, and you get like 11 to 12,000 muscle contractions to your pelvic floor in 28 minutes. And it’s stronger than you can ever give to yourself.
But one of the beautiful things about the chair to is not just the contraction. It’s also the relaxation phase of the chair where you’re now. Your blood vessels are more dilated, bringing a lot more, blood flow to your pelvis. Blood flow is super important for your pelvis, super important for the vagina.
So you get not only the contraction, but you get more blood flow to your pelvic floor. And it’s a, it’s a it’s a treatment that you do twice a week for three weeks. And it helps significantly and is amazing for urinary leakage for, for like cough, sneeze, laugh. Yeah. For the urgency. I got to get up in the middle of the night three times to go pee. It’s fantastic for all of that.
Morgan Allen:
Wow.
Dr. Suny Caminero:
And the women who don’t qualify for it are the women who have, IBS, for example, or women who have a metal because it’s a magnet. So if you have like a copper IUD, you’d, for example, you wouldn’t qualify for that or run out. Or if you have like a hip, like a hip surgery in the past or you have a metal, for the this, this area, if you have metal, then that’s the only disqualification.
So this magnetic chair, does this produce a orgasmic experience for some women?
Dr. Suny Caminero:
It does actually for some women twice a week.
Morgan Allen:
That’s great.
Dr. Suny Caminero:
It’s not that common actually for that experience to happen. But for some women it does do that. But bringing all that blood flow to the floor. I have had women that leave the office, and they have so much more sensation on the public floor that even like the bump on the road that I, I felt that. Wow, I have done the chair. I have not experienced that just because but but those are some of the things that people tell me.
Morgan Allen:
Well, good for them. The lucky ducks of the world. I love that.
So let’s let’s leave this with one thing that you wish every breast cancer survivor knew about reclaiming her sexual wellness.
Dr. Suny Caminero:
The one thing is, there are options for you. You don’t have to live with now. You survive breast cancer. I mean, it’s a miracle. It’s really, very grateful. But you don’t have to live with all the rest of the stuff that comes with it. You there’s definitely options. And if you’re not getting options is not necessarily because your doctor doesn’t want to give you options. Sometimes they’re just not aware of all the options that are available. Okay.
