You’re sitting in an oncology visit and the clock is already beating you. Treatment plan. Side effects. Scans. Mood. Sleep. Work. Family. Fear. The appointment ends the same way it started: packed, fast, and focused on survival.
And then the thing that’s quietly shaping your day-to-day life: desire, pain, dryness, intimacy, the way you feel in your own body, doesn’t get mentioned at all.
In this episode of The Patient From Hell, Samira Daswani talks with Dr. Laila Agrawal about what’s missing from cancer care: honest, practical sexual health support. Dr. Agrawal breaks down what changes after breast cancer, why so many clinicians skip the topic, and what patients can do when no one brings it up.
Episode Highlights
- Why up to 90% of breast cancer survivors may face sexual health changes
- The most common reasons sexual health falls off the oncology visit agenda and what to do about it
- What “low libido” can actually mean, including the difference between spontaneous vs responsive desire
- What genitourinary syndrome of menopause is, why it happens, and why it often worsens without treatment
- Practical options for dryness and discomfort: non-hormonal moisturizers, hyaluronic acid products, and when vaginal estrogen may be discussed
- Why pain with sex isn’t always “just dryness,” and how pelvic floor physical therapy can help
About the Guest
Dr. Laila Agrawal is a physician specializing in sexual health with a focus on oncology patients, helping people navigate the physical and emotional changes that can follow cancer treatment. Her work centers on improving quality of life through evidence-based care for concerns like low desire, vaginal dryness, pain with sex, pelvic floor dysfunction, body image changes, and relationship communication.
In this conversation, she emphasizes that sexual health is part of overall health and that patients deserve real tools, clear guidance, and referrals that don’t depend on luck or who happens to be on your care team.
Pull Quote
“Not all pain is due to dryness and these symptoms don’t usually get better on their own.”
Resources Mentioned
- American Cancer Society (sexuality/intimacy after cancer information
- Breastcancer.org (sexual health resources)
- ASCO (American Society of Clinical Oncology) patient info on sex after cancer
