On today’s episode, we are going to talk about an important topic that is not often talked about – sexual health during and after a breast cancer diagnosis. Sex and intimacy can be difficult for most women after a diagnosis and can cause unique problems, from pain and fatigue to feeling detached or disconnected from the pleasure your body once gave you. Here today to talk to us about thriving sexually during and after breast cancer is Dr. Lyndsey Harper.
Lyndsey Harper, MD is a clinical assistant professor at the Texas A&M College of Medicine. She is also a board-certified OB-GYN that specializes in helping patients with low libido and sexual dysfunction.
Dr. Harper is a Fellow of the International Society for Women’s Sexual Wellness and has dedicated her career to bringing awareness, education and resources to both physicians and patients about these very common, but rarely discussed issues.
A native Arkansan, Dr. Harper earned a BS in Microbiology from The University of Arkansas, then attended The University Arkansas for Medical Sciences to earn her MD. Dr. Harper completed an OB-GYN residency at Baylor University Medical Center in Dallas, Texas, where she worked in private practice for seven years. She is now an Ob-Gyn Hospitalist at Baylor Scott & White Health in Dallas.
In addition, Dr. Harper is the founder and CEO of Rosy, a women’s health company that connects women to evidence-based resources for decreased sexual desire. Rosy’s mission is to alleviate the silence and shame that surrounds women’s sexual dysfunction and to provide women with the help they deserve.
Support for the Real Pink podcast comes from Lilly Oncology. People living with metastatic breast cancer or MBC deserve more. Lilly Oncology aims to bring more awareness of MBC through more education or research and more dedicated solutions to support the women and men living with MBC and the communities that surround them learn more at the More for MBC Facebook page.
From Susan G Komen, this is Real Pink a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room. Our topic for today’s episode is thriving sexually during and after breast cancer. And I’m excited to get to talk with Dr. Lyndsey Harper, OB-GYN, and founder and CEO of Rosy. Dr. Harper, welcome to the show.
So much for having me. I really appreciate it.
Well, this is an important topic. I’m really glad to get to chat with you about it. So tell us a little bit more about yourself. How did you come to understand the importance of women’s sexual health and why are you so passionate about it?
Absolutely. So, you know, as you mentioned, I’m an OB-GYN. And so what that means is that day in and day out, I get to take care of women and really understand what’s going on with them. And so during medical school and residency, OB-GYN are trained really well about how to talk to their patients about contraception, sexually transmitted infections, pregnancy menopause. I can take care of, you know, surgery cancer, but I never got any training on sexual health. And my patients, you know, would, would come to me with very intimate problems, right after maybe after having a baby or a cancer diagnosis. And they would share with me, you know, dr. Harper, I love my partner. I love my husband, but I don’t care if we ever have sex again. And this was happening day in and day out, sometimes multiple times a day, and just leaving me feeling very ill-prepared to help my patients.
And so I started really digging into it and understood that in fact, 43% of women have some sexual problem or complaint, and we’re just doing a terrible job, not only as a society, but also as a medical community, you know, addressing these concerns, giving them the attention that they need and deserve. And that’s getting passed on to our patients who are left, feeling isolated and ashamed and really without answers. And so I became really motivated to learn as much as I could connect with as many people as I could in this space and really try to help women find those answers.
Wow. That’s, I mean, that’s really important and I appreciate that you’re doing that. And so, as you know, we’re doing a series on sexual health and we’d love for you to just help us set the stage and talk about the topics that we’re going to be talking about in the upcoming week. So can you explain it a high level, how sexual problems are often complex and require a multidisciplinary approach and just kind of give us that overview?
Totally. And that’s one I love about sexual health is that it’s not a plus B equals C, right? We are human beings and there’s a lot to what makes, you know, one person who they are and the same goes for each individual sexuality. And so that’s not, not just sometimes, but always a combination of many different things, right? So it’s a combination of how we were brought up when we were younger. What, what sexual education or information or lack thereof did we receive? Where were these conversations always in hushed tones or never happening, or were we able to speak freely and given the language that we needed to discuss sexual concerns and questions, you know, our past experiences really can shape who we are as people and as sexual beings. And so that plays into it, anxiety and depression, other psychological issues can play into it.
And of course, medical issues, for example, breast cancer, but also many, many other medical problems can play into these sexual issues. So what that highlights is how much attention these issues deserve, right? Not how we need to give it 1% of an OB-GYN training, but how we really need to have a full and robust understanding, not only as OB-GYN, but also as people about, you know, how all of these aspects of our lives go into making up the fingerprint of who, you know, each, each person is and represents in terms of their sexuality.
I mean, it’s really helpful how you described it. It’s a very complex thing with a lot of different factors. And so of course, you know, on this show, we’re talking about breast cancer. And so tell us a little bit about the added and unique challenges related to sexual health that arise both during,
After breast cancer, right? I mean, the thing is, is that it is, it is such an opportunity, right? If we’ve never had an opportunity to reflect about ourselves and our sort of sexuality or sexual education, and also in a partnership, if we’ve never had the tools that we needed to discuss sexual problems or concerns, then breast cancer can really be viewed as a time, you know, to really dive into those headfirst because there are so many things that come out of it, right? So first for many of us, we’re facing our mortality that has a huge impact on our mental health, on our relational health, and that really exhibits itself in how we sort of interact sexually. So that’s one huge thing. There’s an aspect of course, with fatigue, right? Not only from the anxiety and stress, but also from the medication from other treatment that may be offered, obviously postoperatively, those that fatigue can really set in some of the medications that are recommended.
Hormone blockers obviously can have a huge effect on us mentally and physically, if we’re thrown into menopause, you know, kind of early and artificially because of these medications that can affect, like we discussed our brain, but also our bodies, our hormone levels are of lower, which can result in vaginal dryness or pain with sex relationally, sometimes things change. And the pain that can happen as a result of these medications or surgery can then affect your partner because your partner in most cases, and we would, one would hope they’re, they don’t want to have a sexual experience where you’re experiencing pain. And so with that goes undiscussed or unresolved, then that can sort of perpetuate and grow bigger and bigger and bigger, you know, if there’s no intervention for that. So definitely it affects women and their partners on both the psychological side and the physical side in many, many different ways.
Yeah. Yeah. That makes a lot of sense. And you know, it strikes me, this is a topic that most people don’t talk about and, but it’s a very real topic and it’s really needed to talk about. So can you just kind of walk us through what your thoughts are related to, why do people not talk about it and why is it so important that we change that? And how do we go about changing that?
Totally. I think that people don’t talk about it because we’re not given permission to do so. Right. And it’s podcast exactly like this, that actually start so many conversations and I’ve seen it time and time again, whenever I speak about this or, you know, have a one on one conversation with a patient, all people are looking for is a safe place in which to have these conversations and what once that permission is granted, you know, it comes out like a waterfall because it’s all these years of questions, of experiences, of emotions that are kind of concealed and contained, and they may bubble up in other ways that we can’t perceive, but they’re there. And until we have the opportunity to discuss those openly, they’re going to continue to affect us negatively. I think that the reason for this is that, you know, this is the messaging that most of us receive throughout our whole lives, right?
When we’re, there are not open conversations like this or with our parents or in our peer groups, or just really anywhere. And in medical training, we get the message that this must not be very important, or this must not occur very often, or if it does occur, maybe there’s not anything to do about it. So unfortunately the party line is drink a glass of wine or go on vacation. And those, those recommendations are not adequate. The in fact, they are much less than adequate and we really should be doing better as a society and for our patients and for each other. And I think that, you know, a field that’s farther ahead of us, obviously as men sexual dysfunction, where there’s a ton of research where there’s a ton of drugs, where whenever a man has prostate surgery, we talk about all of that sexual function and how that will be affected. And we need to really own up to that and women’s health and do as good as they’re doing or, or not, if not even better, because we need to recognize that sexual health is an important part of a woman’s journey, not just for men too.
That’s right. That’s right. And so looking, you know, focusing a little bit more on breast cancer survivors, can you share any specific feedback from breast cancer survivors regarding sexual health resources and what they need?
Absolutely. You know, as we discussed what breast cancer survivors need is valid information, right? They don’t need a thousand websites with not good information. They need a few websites or a few podcasts or a few resources with, with high-quality evidence-based information that will get them to the resources that they need. They need their providers to be open, to and trained, to treat their issues. They need their providers to have a web of people in their communities that can help their patients who are going through and who have completed breast cancer treatment, for example, sex therapist, or regular therapists, physical therapists, sex medicine, doctors, who, who were really trained in these things and gynecologists who are open to talking about sexual issues. So I think it just really supports, right. They, they also need other women and other resources like this one where they can hear, Oh, this isn’t just me. I’m not suffering by myself. And in fact, I don’t have to be silent about it. And the more we are able to talk about it, that in and of itself can be therapeutic for people because it takes away the isolation and the shame that they might be feeling when they realize, you know what, this is actually a really common thing. It’s not just me.
Yeah, that’s right. It is a common thing. And it’s something that we should be willing to talk about. So last question I want to know, what advice would you give to a woman maybe struggling either during or after breast cancer to help her feel empowered, to take charge of her sexual health?
Absolutely. I would really encourage that woman to seek out these evidence-based resources. And there’s lots of different ways to do that through Susan G Komen through rosy, through healthcare providers and really to ask for health care teams, you know, bring up these issues. If you’re having vaginal dryness, let’s talk about it. If you’re having pain with sex, there’s things we can do to help you feel better. If you’re, if you’re having body image issues or changes in the way that you function sexually because of surgery or because of treatment. These are things that need to be brought to the attention of your healthcare team. Unfortunately, you have to be an advocate for yourself and until we can make more progress as a metal community, we’re really going to have to encourage and empower women to do that for themselves. And also maybe to reach out and your support groups, you know, whether you have a friend who has been through it through breast cancer or a wider audience, I’m on a social network, you know, I would say really start conversations in those places about sexual health, because I guarantee you, you’re not the only one.
And by with you starting that conversation, you give that permission that will empower the other women that are around you.
Yeah. And I think it’s probably difficult to start that conversation, but at least once you have sort of permission from, from a podcast or from a conversation with a doctor, I think maybe starting that conversation a little easier, and then hopefully it helps a larger community of people. Right?
Absolutely. It’s that grassroots effect where, you know, we’re all there for one another. We all want to see each other be well and, and our society as a whole. And then this is just another way to really reach out and tell someone else, you know what I see you, I hear you. I get you. And you’re not alone.
Yeah. That’s fantastic. Well, Dr. Harper, this has been really helpful, really informative, very encouraging. And I really appreciate you taking the time to be with us on the show. Love to have you back again some time.
Awesome. Thanks so much, Adam. I really appreciate it.
Thanks for listening to Real Pink, a weekly podcast by Susan G Komen for more episodes, visit realpink.komen.org for more on breast cancer visit komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam, you can find me on Twitter @AJWalker or on my blog AdamJwalker.com. Thanks to Lily oncology for supporting the Real Pink podcast. Join Lily oncology and raising more awareness, education, more research, and more dedicated solutions for metastatic breast cancer. Together we can do more for MBC. Join the conversation at the More for MBC Facebook page.
About This Episode
Intro and outro music is City Sunshine by Kevin MacLeod. Ad music is Trusted Advertising by David Renda licensed from Fesliyan Studios Inc.