56: The Real Talk about Sex After Cancer Treatment with Dr. Michelle Jacobson
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Narrado por:
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De:
The Pleasure Principle 2026
Coven Women's Health
Sexual health after cancer treatment is a conversation that needs to happen more often and with much more nuance. In this episode, Dr. Michelle Jacobson brings her expertise as an OB-GYN and co-founder of Coven Women's Health to break down the real science behind sexual recovery after cancer.
What You'll Learn:
Dr. Jacobson explains the key differences between tamoxifen and aromatase inhibitors and how each affects sexual function differently. We dive into why some cancer treatments leave women feeling like they have "nothing"—no estrogen, increased joint pain, and profound vaginal dryness. She also addresses the safety of vaginal estrogen use post-breast cancer, debunking common misconceptions that prevent women from accessing effective treatment.
The conversation covers practical, evidence-based solutions including the importance of hyaluronic acid moisturizers, choosing the right lubricants (hint: water-based isn't always best), and why coconut oil deserves a spot in your bedroom toolkit. We discuss the crucial role of pelvic floor physiotherapy in sexual recovery and break down the difference between DHEA and estrogen-based vaginal treatments.
For women who've experienced radiation therapy, Dr. Jacobson explains the prevention and treatment of vaginal stenosis, emphasizing why early intervention with dilation and moisturizers makes all the difference. We also tackle the often-overlooked topic of orgasm difficulties after cancer treatment, including how antidepressants, weakened pelvic floor muscles, and changing nerve sensitivity all play a role.
About Dr. Michelle Jacobson:
Dr. Michelle Jacobson is an obstetrician-gynecologist from Toronto and co-founder of Coven Women's Health, a virtual clinic focused on perimenopause, menopause, and cancer survivorship care. Previously the director of the ovarian cancer prevention clinic with a 2.5-year wait list, she created Coven to scale personalized, evidence-based women's healthcare access across Canada.
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