Take Back Your (Sex) Life After Cancer

Take Back Your (Sex) Life After Cancer

by Andrea Santiago Malcolm, LCSW, CST

New love brings new possibilities. It brings the excitement of getting to know someone intimately, both as a person and as a sexual being. You’ll often hear inaugural sex cited as one of the perks of a new relationship. And those people aren’t wrong – exploring sexuality with a new lover can be great. But what happens when life throws a wrench in all that? Say, with a cancer diagnosis? What then? 

Let me tell you. I personally know that chaos. I am a sex therapist, but at the time of my own cancer diagnosis, I was also newly in love and enjoying the sex life that comes with a novel romance. 

Four surgeries later, I had to learn to practice the things I made a living telling other people to do. And I’ll be the first to admit that one of the hardest things to do is practice what you teach. I soon learned that nothing was as easy it as it seemed from my comfy therapist chair. I had to get vulnerable and honest with my new husband and with my doctors. I will never forget that level of embarrassment and vulnerability. I don’t want to leave you out there alone with that either, so I’m going to share some of what I learned along the way. This advice applies whether you’ve just started a brand-new relationship or you’ve been together for 50 years. Let’s dive in.

Redefining What Sex Means 

There is no such thing as a normal sex life. Do not look to television, books, movies, or even your friends for what a normal sex life looks like. I repeat: There is no such thing as a normal sex life. Your normal is going to vary depending on what is happening in your life, how you are feeling, and where you are health wise. 

There is no such thing as a normal sex life. I repeat: There is no such thing as a normal sex life.

Intimacy with your partner can range from holding hands to sexual intercourse, and all of it is OK. It can be fun to make out and enjoy caressing each other without penetration, as you might learn different pleasure spots on each other’s bodies. When it comes to redefining sexual intimacy after cancer, keep an open mind and avoid the comparison trap. Find what works for you. 

Timing is Everything

There’s a myth that says sex should happen at night, usually after dinner. I blame romance novels and Hollywood movies. The reality is most people are tired after dinner and just want to let their food settle. Seriously, who wants to get intimate on a full stomach? Add in pain and exhaustion, and you can easily see how trying to follow this supposed sexual norm can be difficult for cancer survivors and their partners. 


While nighttime might be a wonderful time for hand holding and cuddling, it may not be the best time for sex. Instead, think about what days of the week and what time of day you have the most energy. Then go with it. There’s no set time for intimacy. Just make sure that the stress is off and you’re fully present. THAT time is the right time.

Speaking Up

Sometimes the two toughest people to talk to about sex are the ones we need to talk to the most: our partner and our doctor. When you’re the one facing cancer, it’s easy to forget that your partner is having a tough time too. After all, it’s not their diagnosis – except that anything that affects you also affects your partner. They care about you and want you to be OK. They might be feeling scared too. Plus, it’s common for partners to feel selfish for noticing their own unmet needs, especially sexual ones. They’re probably unsure how to bring it up. They don’t know how to restart or regain intimacy, and may even see it as a frivolous concern in the wake of your cancer diagnosis. Keep in mind that you’re on this journey together. It’s important for both of you to speak openly and honestly about your sexual needs and desires. 

This advice applies whether you’ve just started a brand-new relationship or you’ve been together for 50 years.

Likewise, it’s imperative to talk to your doctor if you’re having any sexual problems, as they may be cancer- or treatment-related. And your doctor may be able to help. However, I know that starting a conversation with your doctor about sex can be difficult for so many reasons. Sometimes we assume that if our doctor doesn’t bring it up then there’s not a problem. The trouble is, the doctor is assuming that too. It is up to you to be proactive in letting your doctor know what you need. Be open and honest with your doctor even if they don’t ask the questions. 

Here are some tips for having those tough conversations with your doctor about restoring sexual function and intimacy after cancer: 

  • I know this is said over and over again, but come prepared with a list of questions. 
  • Be clear about what your goal is: “I want to have intercourse with my partner.”
  • Be clear about what your challenge is: “I am experiencing dryness.”
  • It’s OK to say, “I read about this lotion/exercise/vibrator; is this something that I could try?” In fact, it’s a good idea to talk to your doctor before experimenting with something new if there is any possibility that it could be contraindicated for your specific situation. 

It’s natural to be embarrassed when talking about sex, but don’t let that stop you. Remember that people in the medical community have heard it all. Your doctor won’t even blink. They truly just want to help, and this is a very common side effect that they are used to dealing with. 

Getting Help

I will tell anyone who asks, and even those who don’t, about Ashley, my pelvic floor therapist. A pelvic floor therapist helps men and women deal with sexual dysfunction, sexual pain, vaginal and penile pain, and bowel and urinary problems. After several surgeries and then menopause, I needed help. Ashley was a godsend. Finding someone who specializes in and understands your problems can be a huge relief and can provide you with tools and techniques to get the sex life you want. Your doctor can refer you to specialists in your area.

In Closing

Rebuilding intimacy after cancer can be a new adventure for you and your partner. Like any new undertaking, you will have success and failures. It’s important to remember that the journey to rediscovering intimacy after cancer is just that: a journey. You’re going to learn a lot along the way, and you’ll experience all the emotions that go with that: celebration, fear, anxiety, embarrassment, feeling lost. All of that is OK. 

Try to enjoy the journey as well as your renewed intimacy. And remember to be patient with yourself and your partner. This isn’t easy, but you’re in it together. 

Andrea Santiago Malcolm is a licensed clinical social worker and certified sex therapist in private practice in Boca Raton and Fort Lauderdale, FL. She assists people in finding clarity and new ways to cope with life’s challenges. Andrea loves working with couples who are ready to revitalize their sexuality with a mix of real talk and a sense of humor. She believes that sex is natural, important, and nothing to be embarrassed about. You can contact her through her website, 363therapy.com, or by email at andrea@363therapy.com.

This article was published in Coping® with Cancer magazine, July/August 2018.