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Man, Cancer, Sex

Strategies to Ease the Tension

by Anne Katz, RN, PhD

Prostate Cancer Image

One of the greatest myths in society suggests that all men are sexual machines. The expectation is that men can have sex on demand, at any time, in any place, no matter what his feelings or emotions are. The inference is that if a man can have an erection, then everything is okay. Here’s another myth: Men don’t talk about their feelings and certainly don’t want to talk about sex. Well, the last part may be partially true. It’s not always easy to talk in a meaningful way about sex.

Perhaps the biggest barrier to talking about sex is that we are afraid. What if we say the wrong thing and upset our partner? What if we say a word and she laughs? What if something we say hurts or offends our partner? Will we be rejected or made to feel like a fool for expressing our innermost feelings or fears? How do we talk about it? Here are some suggestions to help you and your partner talk about sex.

Find the Time
Just like any other important discussion you’ve ever had, you need to set aside time to talk about sex. This is not a conversation you should have while rushing to get to work. You probably find the time to plan a vacation, right? So find the time to talk about this important part of your relationship. Any problems you may be having did not start overnight, and they are not going to be solved overnight, either. So when you do talk, remember to plan to talk again, and soon. But set limits for how long you are going to talk. When the conversation is over, it’s over, and should not be strung out over days and weeks.

Just like any other important discussion you’ve ever had, you need to set aside time to talk about sex.

Author of Article photo

Dr. Anne Katz

And when you are planning the time to talk, plan the place, as well. As strange as this may sound, talking about sex shouldn’t happen in the bedroom (or any other place where you have sex). Find a neutral place and turn off the TV, the stereo, and the phone. Lock the front door. Make sure the dog has food and water and has been out for a walk. Interruptions can make a sensitive topic seem even more overwhelming and may break the flow of the discussion or may distract one or both of you from the task at hand.

Name the Problem
You need to decide ahead of time what you want to talk about. And you need to be prepared to discuss it openly, honestly, and constructively. This requires planning, and it is a good idea to let your partner know what you want to talk about. Saying, “Honey, we need to talk about our sex life” is too broad and may be confusing to your partner. What about your sex life? The frequency, the type of activity, your feelings about it? Be clear with your partner so that he or she can also do some thinking ahead of time. A better invitation may be “I would like to talk about the difficulties I’ve been having with erections lately.”

Practice Straight Talk
Talking about sex requires you to be clear in your words and expectations. Many of us think that our partner can or should be able to guess or intuit our needs and feelings. You may know each other very well, you may be able to finish each other’s sentences, and you may even think the same things at the same time, but if you want to solve a problem, then you need to be straightforward and clear about what you are thinking and feeling.

When your partner speaks, make the effort to listen with both ears and your heart and mind.

Tell your partner what you are feeling and why this is happening. The context is very important to avoid your partner thinking that the reason you are feeling this way is something that he or she has done. A vague statement such as “I have no desire for sex” may be interpreted as “He doesn’t love or want me anymore.” And what you really mean is that since your surgery, you are very tired and just don’t have the energy for sex right now.

Use the “I” Word
It is important to talk about yourself and not put words in the mouth of your partner. That’s not fair, and it won’t help your conversation. If you need more direct stimulation since your surgery to get aroused, say something like “I would love it if you would touch my penis with more pressure. Let me show you how I like it.” That’s much more constructive than saying, “You don’t know how to get me excited.”

By talking in “I” statements, you take ownership of your own feelings and don’t put words in your partner’s mouth or assume that you know what he or she is thinking or feeling. And from your partner’s perspective, it doesn’t feel like blame.

Balance the Negative and the Positive
There are different ways of saying things, and how you say something can really influence how the message is received. “You make me crazy with your demands for sex” has a very different tone from “I don’t want sex as often as you seem to.” Sometimes when talking about sex, we have to say things that may seem hurtful or may appear to our partner as a criticism. Balancing the positive and the negative is a delicate negotiation but, if done carefully, can protect feelings and reduce the risk of causing hurt.

Actively Listen
When your partner speaks, make the effort to listen with both ears and your heart and mind. Don’t think about the mess in the garage, what you have to do at work tomorrow, or how you’ve had the conversation before. Empty your mind of past memories and future plans and truly listen. When you are actively listening to your partner, let go of your own thoughts and opinions for a moment or two, and you may be surprised that your partner’s position is not that far from yours.

Get Help
Don’t wait until you are faced with a crisis to get help. Marriage and sex therapists specialize in helping couples to understand what is affecting their relationship and, more importantly, helping them to find a better way of talking, reacting, or loving.

Men often think that they have to solve every problem or crisis, and this extends into their relationships. Being part of a couple means that resolution of problems needs to be shared, so don’t think you have to fix it – work on it together. Communication is central to all our relationships. But we all need practice in getting it right.

♦ ♦ ♦ ♦ ♦

Dr. Anne Katz is an author and the sexuality counselor at CancerCare Manitoba in Winnipeg, Manitoba, Canada.

Excerpted with permission from Man Cancer Sex by Anne Katz, RN, PhD, copyright © 2010 by the Oncology Nursing Society. All rights reserved. Copies of the book may be purchased through the Oncology Nursing Society at

This article was published in Coping® with Cancer magazine, September/October 2012.