Up to 90% of breast cancer survivors experience sexual health changes, yet almost no one is talking about it.

Today on Patient From Hell, host Samira Daswani sits down with Dr. Leila Agarwal, a leading clinician in oncology sexual health, to break the silence around libido loss, vaginal dryness, pain, body-image shifts, dating after cancer, orgasm changes, pelvic floor dysfunction, and how treatment impacts intimacy.

This episode answers the questions patients wish they could ask, but rarely get time for in an oncology appointment.

If you've ever wondered:

“Is sex safe during treatment?”

“Will my desire ever come back?”

“Should I use vaginal estrogen?”

“What’s normal to feel?”

— you’re in the right place.

Sexual health concerns in breast cancer are common, treatable, and deeply misunderstood. Dr. Agarwal explains:

- Why oncologists often avoid sexual health conversations

- The real reason libido drops during and after treatment

- The truth about vaginal estrogen and hormone-positive breast cancer

- How to talk to a partner when desire shifts

- How single women can navigate dating after cancer

🧠 Guest: Dr. Laila Agarwal

Dr. Laila Agarwal is a nationally recognized expert in sexual health for oncology patients. She specializes in survivorship care, menopausal symptoms, pelvic health, pain management, and evidence-based approaches to sexual wellness throughout cancer treatment. She is passionate about removing stigma and giving patients the tools, language, and confidence to advocate for their sexual well-being.

Chapter Codes

00:00 – Why sexual health is overlooked in oncology

01:45 – How many breast cancer patients struggle with sexual health

03:15 – Why oncologists avoid the sex conversation

05:02 – Biggest myths about sex during/after treatment

06:07 – Low libido: what’s actually happening

08:20 – Responsive desire vs spontaneous desire

09:50 – Vaginal dryness: causes, range, and treatment

12:34 – Moisturizers, hyaluronic acid & home remedies

13:45 – Vaginal estrogen: safety, controversy & guidelines

15:41 – Menopause, hormone shifts & severity of symptoms

17:30 – Pain during intercourse & pelvic floor dysfunction

19:27 – What to do if your cancer center lacks specialists

20:58 – Body image & sexuality after mastectomy

22:57 – Body image vs desire — how they interact

24:42 – When to see a sex therapist vs medical provider

26:29 – Partner communication and relationship impacts

28:10 – How to set boundaries without losing intimacy

29:55 – Dating during or after treatment

31:19 – How treatment affects ability to orgasm

33:28 – Is sexual recovery tied to treatment timing?

34:58 – Should you feel guilty for wanting sex after cancer?

35:40 – Myth busting: sugar, condoms, recurrence risk & more

36:37 – Is sex safe with a chemo port?

37:10 – Best sexual health resources for cancer survivors

About Patient From Hell

Patient From Hell is hosted by cancer survivor and founder Samira Daswani, who asks the questions most patients are too overwhelmed, or too afraid, to ask.

The show brings together doctors, researchers, advocates, and survivors to reveal evidence-based answers for patients navigating the chaos of cancer.

Subscribe for episodes that blend science, compassion, and clarity without the medical jargon.

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