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Let’s Talk About Sex

by Melissa Donahue, MSW, LCSW, OSW-C, CST

Sex is normal human behavior; however, it can be an intimidating topic to discuss with your doctor. It is important to remember that we are all sexual beings whether we are with a partner or alone.

The goal of cancer treatment is to treat the person as a whole, and sexuality is a part of our whole person. When your sexual function doesn’t return to its prior state after cancer treatment, it is a topic that should be discussed with your doctor, but more importantly, with your partner first.

Very often at the beginning of treatment, fertility is the only sexuality concern that is discussed, but there are so many other layers to sexuality that need to be addressed. Sexuality is not just about fertility or the physical act. It also includes body image, intimacy, and loss of desire. Even still, given the sensitivity of the situation, many people may feel uncomfortable discussing the topic.

Body Image
Many survivors find that during or after treatment they are mourning the loss of their former physical appearance – their hair is different, their weight may have changed, they have new scars and skin changes. All these body changes are normal during treatment for cancer, but they can leave a person feeling less attractive or even concerned about how others may view them.

The act of sex is often looked at as something healthier people practice, so when you are sick, it can be a low priority.

Here are some simple suggestions to help you deal with some of these physical changes:

• Alter the lighting in the bedroom; pink light bulbs are more forgiving.
• Find a clothing item that makes you feel attractive: it can be a scarf, a pair of earrings, or a new hat.
• Attend a makeup program through the American Cancer Society or at a local department store. A change in makeup color can make a difference.
• Remember that your partner is not with you just for your good looks.

Intimacy
Emotional connections can sometimes build a stronger bond than the physical act of sex. It starts with our feelings about ourselves, our partners, and the bond we have between us. Finding ways to build upon that may bring you back to the days of dating. Sharing your feelings, goals, dreams, and fears will help build that connection you once had. Holding hands, cuddling, or spending quality time together are simple ways to strengthen your bond.

Loss of Desire
Sometimes, fatigue associated with chemotherapy or radiation leaves little energy for everyday activities, let alone sexual activity. After treatment ends and your stamina returns, your fatigue will decrease, and your desire may return. Keep in mind, desire is not only related to fatigue. Other issues can cause a dip in your desire: hormonal changes, depression or anxiety, relationship troubles, and lifestyle changes. Utilizing the times of the day when you have more energy or having a special night out may help create a better setting for desire.

Talking with Your Doctor
Not many people address their concerns about sexuality at the beginning of treatment. At the beginning, many people are trying to adjust to their diagnosis and treatment.

The act of sex is often looked at as something healthier people practice, so when you are sick, it can be a low priority. Often when people do mention their concerns, it is generally post-treatment. Instead, sexuality concerns should be addressed early on.

However, you should never feel that it is too late to address these concerns. Sometimes, simple changes can make a big difference. When you feel that you have done all you can at home and you need the help of a professional, use these tips to help you address this issue with your doctor:

• Bring up the topic, even if the medical professional doesn’t. This is just as important as any other side effect you may have experienced.
• Don’t feel embarrassed for yourself or the professional; after all, you did talk about your bowel habits during treatment.
• Tell your doctor what your desired outcome is. It may be an easier fix than you think.
• Not every oncology professional is well trained in sexuality concerns. If your doctor isn’t able to address your concerns, ask to speak with an oncology social worker, or get a referral to someone who can.

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