Cancer can put a strain on intimate relationships. Treatments for cancer and the disease itself may cause changes in sexual desire and function. If your physical appearance has changed, you may feel less attractive or desirable. At the same time, your partner may feel helpless, fearful, or unsure of how to support you. Any of these issues can form barriers to intimacy.
The causes of sexual dysfunction are often both physical and psychological. Cancer and its treatments, particularly those involving the genital or reproductive organs, may directly affect sexual functioning and desire. The side effects of cancer treatments, like fatigue, nausea, pain, and other physical discomforts, can also reduce sexual feelings.
In addition, you may feel anxious or depressed, which can impede sexual desire and functioning. These feelings may become amplified if your physical appearance changes due to surgical scars, hair loss, weight changes, or other treatment effects. These physical changes may make you feel unsexy or insecure.
Sexuality Issues for Women with Cancer
Women face unique challenges regarding sexuality and intimacy during cancer treatment.
Common issues include:
Loss of libido (sex drive)
Painful intercourse
Vaginal dryness
Loss of sexual function or sensation
Emotional issues (e.g., anxiety, depression, guilt)
Body image issues
Fatigue
Onset of menopause
Vaginal dryness is common for some women with cancer, making sex painful. Often, this dryness and discomfort are caused by declining estrogen levels. Some cancer treatments may also trigger early menopause, resulting in hot flashes, mood swings, decreased libido, and vaginal dryness or tightness.
Additionally, some types of pelvic surgery (e.g., removal of the uterus, ovaries, or bladder) may decrease vaginal lubrication and sensation, contribute to loss of vaginal elasticity, and cause pain. Breast cancer surgery may reduce physical sensation, so the breasts may not be the source of pleasure they once were. Radiation therapy to the pelvic area may change the vaginal lining, making intercourse painful.
Solutions:
Discuss concerns with your doctor, who may recommend treatments like estrogen replacement therapy, vaginal dilators, lubricants, or estrogen creams.
Counseling can address body image issues and provide emotional support.
If you want to have children in the future, discuss fertility options with your doctor.
Sexuality Issues for Men with Cancer
Men also face specific challenges regarding sexuality and intimacy during cancer treatment.
Common issues include:
Erectile dysfunction (impotence)
Inability to ejaculate or reach orgasm
Loss of libido (sex drive)
Incontinence
Emotional issues (e.g., anxiety, depression, guilt)
Body image issues
Fatigue
Concerns about sexual performance
Some treatments for men with cancer may interfere with the ability to have an erection, ejaculate, or reach orgasm. Surgeries for prostate, bladder, and colorectal cancers may damage nerves and blood vessels, resulting in erectile dysfunction (ED) and issues with ejaculation and orgasm. Radiation therapy to the pelvis may damage the arteries that bring blood to the penis, causing problems with erections and incontinence. Chemotherapy may interfere with testosterone production, affecting sexual function. Hormone therapy for prostate cancer can reduce hormone levels, impacting the ability to achieve an erection or orgasm.
Solutions:
Discuss concerns with your doctor, who may recommend nerve-sparing methods during surgery to preserve erectile function.
Treatment options may include medications, injections, vacuum devices, implants, or testosterone replacement.
Counseling can help with emotional distress and body image issues.
Discuss fertility options if you want to have children in the future.
Balancing Cancer and Intimacy
Intimacy means different things to each of us and can be expressed in various ways. When cancer impacts your life, roles and relationships change. For many, an intimate connection with a partner is an important part of feeling alive and whole during cancer treatment. While it may take persistence and teamwork to maintain intimacy in your relationship, it can be done.
Tips for rebuilding intimacy:
Give yourself time: You and your partner need time to adjust to the physical and emotional changes cancer causes. Be patient if certain side effects lower your desire for sexual activity. Give yourself time to come to terms with changes to your body.
Communicate with your partner: Open communication is key. Talk about your feelings, fears, and any physical discomfort you may be experiencing. Understanding each other’s needs and preferences is crucial.
Make necessary adjustments: After cancer treatment, some sexual positions may hurt, and certain activities that once gave you pleasure may not anymore. Explore and guide your partner on what feels comfortable.
Validate each other’s feelings: Listen to each other’s concerns without interrupting or being dismissive. Empathize and try not to take things personally. Support each other through this journey.
Get reacquainted: Emotional closeness and companionship are important. Start slowly by cuddling, kissing, and touching. Spend quality time together and express your love daily.
Experiment with other forms of intimacy: Even if you can’t have sexual intercourse, maintain intimacy through loving affection and touch. Focus on the sensual, not the sexual. Engage in activities that bring you closer.
Plan ahead: Levels of sexual desire vary during cancer treatment. Plan intimate moments for when you have the most energy or after taking pain medication. Separate caregiving time from couple time.
Talk with your doctor: Discuss any concerns with your doctor. They can provide insights on the impact of cancer treatment on sexual function and suggest solutions for sexual dysfunction.
Seek professional help: A counselor can facilitate communication between you and your partner. Support groups can also provide a space to voice fears and concerns, helping you find new ways to build intimacy.
Work as a team: During cancer treatment, teamwork is crucial. Closeness and companionship from working together can help you feel more secure and in control. By communicating effectively and making an effort to maintain intimacy, your relationship can flourish in the face of cancer.
Cancer can be a challenging journey, but with patience, communication, and mutual support, maintaining intimacy with your partner is possible. Remember, you’re not alone, and there are resources and professionals available to help you along the way.
