How Can Breast Cancer Affect Your Pelvic Floor? - Vital Physiotherapy

How Can Breast Cancer Affect Your Pelvic Floor?

03 Oct How Can Breast Cancer Affect Your Pelvic Floor?

October 1st marked the beginning of National Breast Cancer Awareness Month. More often than not, we work with clients following their chemotherapy, radiation, and/or surgical interventions. However, supporting our clients wherever they are in their breast cancer journey is an integral part of the care we provide at Vital. 

When it comes to breast cancer treatment, the medical community continues to make significant progress in support, prevention, detection, diagnosis, treatment, and care. As a result, we are seeing more and more women survive – in fact, the current 5-year survival rate is now 87% (1)! As well, with the incredible advances in breast cancer screening, we are seeing an increasing number of women opt for risk reducing surgery. This means we need to consider the impact breast cancer treatment has on quality of life down the road – we want to ensure our clients are supported and empowered through every step of the way!

Pelvic health is one area of wellness that is often shrouded in mystery – even more so as it pertains to breast cancer. It’s a surprising area of concern for many of our clients as they rehabilitate from breast cancer treatment, transition into remission, or navigate life cancer free. That said, we are ready to shed some light on the two most common (and related!) pelvic health challenges we hear from our women who have journeyed with breast cancer: vaginal dryness and painful penetration.

Vaginal Dryness and Painful Penetration 

Vaginal dryness is a common side effect of a number of different breast cancer treatments (2,3). Hormone therapy, chemotherapy, prophylactic and risk reducing surgeries such as hysterectomies (when the uterus is removed) and oophorectomies (when the ovaries are removed) can all cause the walls of the vagina to become drier, thinner, and produce less lubrication. Some women may find that penetrative sex is not as enjoyable as before. They may find it uncomfortable, or even downright painful! The discomfort caused by vaginal dryness can also lead to muscle guarding and an unconscious protective response in the pelvis, making the discomfort with penetration even more pronounced!

So what are you to do?! When you are ready, here are some of my top pelvic health tips to help you return to pain free, and dare I say, pleasurable penetration!!

Our Tips For Vaginal Dryness and Painful Penetration:

1)   See a Pelvic Health Physiotherapist!! You had to know this one was coming! Intercourse and penetration should always be enjoyable and pleasurable. If you’re experiencing pain, discomfort, lack of enjoyment, burning and/or stinging with penetration you NEED a pelvic health Physio. Your physio can help you determine whether the discomfort you’re having is due to the dryness itself, muscles that are guarding in the pelvis, or a result of other concerns associated with persistent pain! If penetration is something you desire in your sexual life, your pelvic health physio can prescribe exercises and treatment so you can address vaginal dryness and irritation, and get back to enjoyable penetration!

2)   Lubricant is your friend!! Although lubricant won’t address dryness and painful penetration altogether – it can certainly help and is part of a well-rounded treatment plan. Our favourite water based, paraben free pick is Slippery Stuff! 

3)   Foreplay is also your friend!! You can never have too many friends right? You wouldn’t expect an opera singer to hit the high notes without a warm up would you? Needless to say, we shouldn’t ask the same of our bodies. Foreplay is important to help you build arousal and warm-up your pelvic floor muscles which in turn, will allow you to better self-lubricate and release your pelvic floor muscles! 

4)   Speaking of releasing your pelvic floor muscles – Diaphragmatic Breathing Exercises can help to release and relax the pelvic floor muscles as well. Making them apart of your daily routine can help to mitigate tension and guarding of the pelvic floor muscles. Relaxed muscles, are more flexible and less likely to contribute to painful penetration.

5)  Play around with positions and keep an open mind. Get creative! Some positions may be more comfortable than others so try a few different ones and see what feels most enjoyable for you and your partner(s)! Keep in mind that there are many ways we can be intimate beyond penetration and intercourse. There is no rule that says enjoyable sex has to include penetration!

6)   See your Healthcare provider (Family Doctor, Gynaecologist, Nurse practitioner etc.) to discuss vaginal moisturizers, suppositories and creams. Vaginal moisturizers are different from lubricants. Lubricants you use immediately prior to penetration or intercourse, whereas vaginal and labial moisturizers are typically applied on a regular basis to maintain and replenish vaginal moisture. Damiva products such as the Mae and Cleo are fantastic all natural alternatives to other prescription creams! While you are at it, ask your doc about hormones and what they can do to help! Keep in mind that vaginal dryness can be caused by infection as well so it’s always best to keep your Doc in the loop and consult them for their opinion!

Breast Cancer can change a number of different aspects of pelvic health and sexuality (4), and while these tips can help get you started, if you have questions or concerns don’t hesitate to reach out to us here at Vital! Email us at [email protected] or call 416-551-0900, we’d love to help in any way we can!

Want to know more about pelvic health and breast cancer? Experiencing discomfort or lack of enjoyment with penetration? Email me at [email protected]! I’d love to hear from you!!


About the Blogger

Sara is a Pelvic Health Physiotherapist at Vital! Known for her empathetic nature and positive energy, Sara works side by side with her patients to understand their needs, concerns, and goals. Viewing her client’s health holistically, she works diligently to empower and motivate them along their rehab journey! Have questions? You can connect with Sara via. Email at [email protected]!!



  1. Canadian Cancer Society. October is Breast Cancer Awareness Month.
  2. Coady, D. and Kennedy, V. Sexual Health in Women Affected by Cancer: Focus on Sexual Pain. Obstetrics and Gynecology. v.128(4), 2016, pp. 775-91.
  3. Davies, SR. Panjari, M. Robinson, PJ. Fradkin, P. and Bell, RJ. Menopausal Symptoms in Breast Cancer Survivors nearly 6 years after Diagnosis. Menopause. v.21(10), 2014, pp.1075-81.
  4. Sh, V. and Kashani, LF. Sexuality After Breast Cancer: Need for Guideline. Iranian Journal of Cancer Prevention. vol 5(1), 2012, pp.10-15


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