Is There Sex After Cancer?
by Margaret Wilmoth, PhD, MSS, RN, FAAN
Many of you may be asking yourself just that question now that you have moved beyond the initial crisis of cancer diagnosis. What parts of my life have changed? How have my cancer treatments affected my ability to be sexual? Am I still allowed to be a sexual person and engage in sexual intimacy? Am I the only person with these concerns and unanswered questions?
The answer to those last two questions is yes, it is wonderful to celebrate life and living by being sexually intimate, and no, you are not the only person with these concerns. How you resume your sexual intimacy may – or may not – have been affected by the cancer treatments you have undergone.
What you should expect from your healthcare provider is a full discussion of the sexual consequences of your treatment as part of the informed consent process. Knowing the sexual side effects of treatment is just as important as knowing about hair loss, fatigue, or chemotherapy-induced nausea. If this information is not offered, ask! Just because your healthcare provider does not mention sexuality, it does not mean that it’s not important.
In general, surgery can affect both the appearance of your body and, depending on the type of surgery, your ability to function sexually. Fertility may be affected if surgery involves removal of the reproductive organs. Chemotherapy can lead to temporary or permanent loss of fertility in both men and women. This, along with temporary hair loss and other physical side effects, can affect how you feel about yourself as a sexual being. Radiation therapy can also affect fertility, erectile function, and body image. Moreover, systemic issues, such as fatigue, can affect your interest in sexuality and intimacy.
Knowing the sexual side effects of treatment is just as important as knowing about hair loss, fatigue, or chemotherapy-induced nausea.
There are things you can to do minimize many of the sexual side effects of cancer and its treatment. After breast cancer, for example, women may experience numbness around the breasts. If caressing the breasts was important to you before cancer, know that it will take time for the numbness to recede. Some gynecological procedures can shorten the vagina, making intercourse painful. Postoperative education by your nurse should include explanations of sexual positions that may reduce discomfort during intercourse. Treatment-related vaginal dryness can be improved by using an over-the-counter water-based vaginal lubricant. If you experience treatment-induced menopause, you should talk with your healthcare provider before taking any medications (including herbal remedies) designed to reduce menopausal symptoms. Many of these medications may be contraindicated for certain types of cancers, and some can actually harm you.
Men may experience treatment-induced erectile dysfunction, depending on the type of cancer and treatments used. You should discuss options for managing erectile dysfunction with your doctor. Additionally, it is critical that you discuss options for sperm banking before starting any treatment if you are a young man diagnosed with any type of cancer, particularly testicular cancer.
You may want to consider joining a support group where you can gain helpful insights from other survivors on how to negotiate the changes that cancer brings about. If sexuality is not discussed in your support group, mention it! Talking with others who have “been there” can provide hope (as well as laughter) through shared experiences.
Rest assured. There is a sexual life after cancer.
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Dr. Margaret Wilmoth is a professor in the School of Nursing at the University of North Carolina-Charlotte.
This article was published in Coping® with Cancer magazine, September/October 2009.