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Is There Sex for Women after Cancer?

by Anne Katz, RN, PhD, and Don S. Dizon, MD, FACP

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One of the more common side effects of cancer and its treatments is sexual dysfunction, which includes alterations in body image, changes in normal arousal patterns, and diminished ability to have and enjoy intercourse. All of these issues can take an emotional toll on both the woman with cancer and her partner, and too often, they aren’t addressed.

However, women treated for cancer deserve to have their sex lives back. After all, life after cancer must be worth living, and for those women whose sexual selves are important, this is important. Here are some suggestions for reconnecting to your sexuality.

Don’t suffer in silence.
The first thing you should do if you’re experiencing sexual problems after cancer is talk about them with your partner. Even though this can be a difficult conversation, tell your partner what you’re thinking and feeling. Your partner is likely aware that something is not right but may be afraid to bring it up.

Even though your doctor may not ask about your sex life, don’t be afraid to be the one to bring it up.

Author of Article photo

Dr. Anne Katz

Take care of yourself.
Mindfulness-based meditation and physical exercise have both been shown to be helpful for women by reducing stress, encouraging sleep, reducing fatigue, and lifting mild to moderate depression.

Seek out help.
Women should expect their primary care doctors and their oncologists to review issues that may linger after cancer treatment, including sexual problems. But even though your doctor may not ask about your sex life, don’t be afraid to be the one to bring it up. You can ask, “Do you know who I can talk to about sexual matters?” Or bring it up in response to the question, “Is there anything else you’d like to discuss?” Women should feel empowered to seek out advice and solutions, and there is no reason to expect less when it comes to sexual functioning.

Author of Article photo

Dr. Don Dizon

Talk to a sexuality counselor or therapist.
This can be very helpful and can provide a safe environment in which you and your partner can communicate. This type of therapist can also suggest different ways of doing things and recommend products that can help.

Take care of your vaginal health.
After cancer, women may experience vaginal dryness and pain with vaginal penetration. However, most women don’t use an effective vaginal moisturizer (for daily comfort) or lubricant (for sexual activity). These can be effective at easing vaginal symptoms. If there is pain with penetration, ask your healthcare provider about using vaginal dilators.

Moisturizers (like vitamin E oil or K-Y® Liquibeads®) can be used to maintain vaginal health. Lubricants should be used liberally prior to penetrative intercourse, as they help to make penetration more comfortable. It is very important not to use anything that is warming, cooling, or intensifying, as these contain irritants that can just make things worse.

Hormonal-based preparations, like estrogen cream or low-dose vaginal estrogen tablets, can also be used to promote vaginal health. However, these should only be prescribed after discussing the risks and benefits with your oncologist and primary care provider.

Rediscover intimacy.
Sexual activity and emotional intimacy are complementary, but they are not the same. They are, however, equally important. Emotional intimacy can help reconnect you to your sexual self. Find ways to help bring you and your partner closer, perhaps by placing an emphasis on holding hands, hugging, and kissing instead of intercourse. These simple activities can yield significant benefits.

Make your sexuality a priority.
Part of rediscovering your sexuality is to make it a priority. Don’t wait for things to get better. Instead, invest the time to work on it. Depending on how long it has been since you were sexually active, it may take months before you feel like there’s been progress. Stick with it, and continue to work with your doctor and sexuality counselor or therapist. Like many things in life, if your sexuality is important, it’s worth fighting for.

♦ ♦ ♦ ♦ ♦

Dr. Anne Katz is an AASECT-certified sexuality counselor who has authored several books, including Woman Cancer Sex. Dr. Don Dizon is a specialist in medical gynecologic oncology at the Gillette Center for Women’s Cancers at Massachusetts General Hospital in Boston, MA.

This article was published in Coping® with Cancer magazine, January/February 2013.