Cancer isn’t sexy—but facing the disease shouldn’t put a damper on your sex life, according to Claire Postl, a licensed professional clinical counselor who specializes in sex therapy at the Ohio State University Wexner Medical Center.
“Cancer can be a rare opportunity to explore sexuality again because everything is going to change,” she says. “It can be different, but that doesn’t mean it’s not going to be great.”
Read on to learn about common intimacy issues cancer survivors face, as well as tips that patients and partners can use to have great sex after cancer.
What are some common intimacy issues you see in cancer survivors?
For women, sometimes they have vaginal dryness, they have muscle tension—called vaginismus or dyspareunia—which is the tightening of the pelvic floor muscles, so it makes some people have pain with penetration. Low desire changes—someone who maybe had a lot of sexual desire tends to have a little bit lower desire, especially women who are pushed into menopause after cancer treatment. For men, I see a lot of erectile issues, so erection changes and sometimes people have anorgasmia, a delay or absence of being able to reach orgasm. Men will sometimes report some desire changes, too. There tends to be a lot of preoccupation when someone is diagnosed with cancer. They’re not thinking, Oh, I should have some sex today; they’re thinking, What is my next step in treatment to be healthy? Cancer tends to do that. It’s a very preoccupying sequence of events. Other things I see are body image changes that impact intimacy, so some people who lose certain parts of their body due to cancer tend to have a big difficulty adjusting to that. Some people will report lower self-esteem, lower sense of femininity or masculinity, and those are identity things for us. So we identify as men or women or something in between, and to have that shifted can be very difficult for some people. I also see a lot of anxiety. Fearing not being able to pleasure a partner as much, fearing not being able to do the same things we used to do sexually, not being able to be intimate in the same way. And there’s depression. It can have a really big impact on sexual functioning.
What’s more difficult to deal with, physical changes or mental blocks?
They’re so interconnected. Think about it like a big web. Body changes can cause self-esteem concerns, which can cause depression or anxiety. We can treat certain things, and I think that is really good. The physical aspects we can often get a hold of—they can start Viagra or Cialis to improve their erections, and women can go to pelvic floor physical therapy to help with the muscle tightening. They can use vaginal moisturizers that can help with tissue dryness and help with pain. We can treat the symptoms, but these are added steps that people have to take that impact their sense of self. Even if we can treat it, it still can be a big loss for some people. Maybe the spontaneity isn’t there as much, maybe their sense of being a man or woman is altered by having to take a pill or having to add a step of using a dilator before sex. It would be really hard to parse it apart to say which one is easier to treat.
What are some other steps survivors can take to enjoy intimacy again?
Cancer can be a rare opportunity to explore sexuality again because everything is going to change. Things that maybe felt good at one point before cancer could not feel as good now, or a body part that you had a lot of sensitivity with, like breasts or nipples, that changes. It’s having to relearn what they like and what they don’t like. It can be an opportunity to practice other types of intimacy with a partner and learn more about yourself as a sexual person. Often I see people who have cancer and who go through treatment and they’re just like, Oh my god, this is a huge loss because the way we used to have sex and the way we used to engage intimately just doesn’t work anymore. And that can feel really defeating. Explore different types of touch, explore different sensations. Just touch each others bodies all over and see what feels good. Be very in the moment. Date each other. You can do something new and rebuild something great. It can be different, but that doesn’t mean it’s not going to be great.
How can partners be supportive throughout this process?
A partner should go to all appointments. I think when someone is first going through treatment, everyone will be at these appointments, but as you’re getting healthier and treatment is working, sometimes partners and caregivers stop attending. We don’t want to have to play a game of telephone, so as a partner, be there to support the patient and to also collect the information. To know what the treatment plan is, to know what the course of treatment is to regain sexual functioning or to learn or develop a new sexual repertoire. Also—and this one is a pretty big one—knowing that just because a patient has completed treatment doesn’t mean the struggle is over. Often when people are going through treatment, it’s a very stressful experience and very exhausting, physically. Being really empathetic is also a struggle. One of the things I see often is a shift that happens in relationships: When someone gets cancer or gets sick, they go from a partner-partner relationship to a patient-caregiver relationship. The transition out tends to be really difficult. Sometimes people will feel like, OK we’re done with treatment. We’ve made it out of this need for patient-caregiver, but the patient is still really struggling. So the caregiver jumps back into partner, and the patient is not ready yet. That can cause a lot of frustration, a lot of desire discrepancy, mixed resentment and emotions. Being able to understand that just because treatment is ending doesn’t mean that the patient is quite ready to jump back into partner-partner.
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Benefits of using VuVa Dilators:
Allow you to have intercourse with less discomfort.
Neodymium Magnets relax and stretch muscles before intercourse.
Desensitizes painful areas of the vagina.
Reduces the fear of penetration.
Neodymium Magnets create blood flow to the vaginal walls to promote relaxation and healing.
Prevention of adhesions/fibrosis from forming during and after pelvic radiotherapy.
To learn more about VuVa Vaginal Dilators visit www.vuvatech.com