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When Cancer Affects Your Sexual Health

by Mindy R. Schiffman, PhD

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It is important to stay physically close, even when sex is not on the agenda.

A cancer diagnosis is life changing. In addition to the emotional jolt of confronting your own mortality, you may experience physical changes that affect your body image and sexuality. The sexual response is exquisitely sensitive to change, even under “normal” circumstances like a new partner, a different room in your home, or even the time of day. Suffice it to say, cancer and its treatments can have an enormous impact on sexuality. And if you’re in a romantic relationship, your partner may also be left reeling in cancer’s wake.

Who is at risk for sexual dysfunction after cancer treatment?
Those with dramatic changes to their bodies, or whose cancer affects a reproductive organ, are at greater risk for sexual prob­lems following treatment. Moreover, if your romantic relationship, body image, or sexual functioning were already troubled, cancer will likely exacerbate those problems. Chronic pain or fatigue, as well as untreated depression or anxiety, can also impede a cancer survivor’s re­turn to a healthy post-cancer sexual life.

What are some common sexual problems men and women face after cancer treatment?
Women are apt to feel less desire to be sexual, as well as decreased sexual pleasure. They may also experience pain during penetration due to a decrease in the body’s natural lubrication. Men are more likely to worry about getting and maintaining an erection, which can lead to avoiding sexual encounters. They may also ex­perience a decrease in sexual desire.

Author of Article photo

Dr. Mindy Schiffman

What are some things my partner and I can do to reestablish sexual intimacy?
It is important to stay physi­cally close, even when sex is not on the agenda. Continue to kiss, touch, and caress each other. Engage in activities outside of the bedroom that might help nurture your sexual interest. Write each other love notes, go out dancing, enjoy a romantic dinner. You and your partner may also need to reestablish how to initiate sex and redefine what your focus is during a sexual interaction. This means you have to talk to one another – about sex.

Many people think they shouldn’t have to talk about sex; lovers should just know what to do. However, sex therapists have long advocated that communicating your sexual concerns and desires is the gateway to better sex. Talk to your partner about your worries, your wishes, and your desires. Initiate these conversations outside of the bedroom, not in the midst of a sexual interaction, and speak in a non- confrontational, conversational tone.

After cancer, you may also have to change how you think about sexual en­counters, specifically, when they should occur and what you feel comfortable doing. Some people believe that sexual encounters should be spontaneous; how­ever, after cancer, desire just may not be there. Don’t wait to be “in the mood” to initiate sexual or sensual contact. Instead, plan some time for sensual interludes that may (but do not necessarily) lead to a sexual interaction. Before each one, discuss your sexual limits as you work your way back to a more spontaneous, fluid sexuality. For example, you may want to begin with kissing and non-genital touching, then gradually move to increased levels of sexual intimacy. When you set aside time to focus on intimacy, keep your thoughts on sexual images or fantasies; with touch, arousal is likely to follow.

You may also need to reframe your definition of sex. Sex is not just inter­course. Instead, think about sex as sensually pleasing activities that you and your partner take turns giving and receiving. The focus of sex should be on intimacy and pleasure, not a specific outcome. This will help take the pres­sure off “performance.” Penetration and orgasm are not the goals; pleasure is.

As you become more comfortable with your post-cancer body and begin to reestablish inti­macy with your partner, experiment with different positions to attempt intercourse. Always use a water-based lubricant, which increases arousal and decreases pain. And be sure you are both ready for pen­etration before proceeding.

You can expect that there may be awkward moments. You or your partner just may not respond as you once did, or even as you would like to. Try to maintain a sense of humor. Remember, sex is supposed to be about intimacy and pleasure, not about pressure and proving yourself.

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Dr. Mindy R. Schiffman is a clinical psycholo­gist at the New York University Langone Fertility Center, a clinical instructor in NYU’s obstetrics and gynecology department, and a certified sex therapist and supervisor. She also has a private practice in individual and couples counseling. Dr. Schiffman specializes in helping people cope with the emotional stress of illness, including reproductive loss, sexual dysfunction, grief and bereavement, and interpersonal conflict.

If you find that your sex life isn’t improving, even after attempts to restore intimacy with your part­ner, talk to your doctor. He or she can answer your questions, refer you to a specialist, and help you find solutions.

This article was published in Coping® with Cancer magazine, May/June 2016.