By now, if you’ve spent any time in a cancer support group, whether in person or online, then you’ve probably talked a lot about sex. Cancer and its various treatments, chemotherapy included, can devastate your sex life, and this can contribute to relationship tension, depression and decreased quality of life. For most people, sex is an important part of life. Figuring out how to make sex enjoyable again after chemotherapy is key to feeling fully recovered.
Chemotherapy disrupts your sex life for several reasons. For most people, chemo interrupts hormones. Many chemo regimens include medications that are hormone blockers, such as leuprolide (Lupron) or tamoxifen. These medications block the action of estrogen and testosterone at the target organ in body, thus putting the body into a hormone-deprived state. This interruption in the functioning of the sex hormone system causes several symptoms, such as erectile dysfunction in men, vaginal dryness and pelvic pain in women and low libido (sex drive) for everyone.
Chemotherapy can also interrupt the sex hormones even if a hormone-blocker is not part of your chemo regimen. This happens in women when the ovaries are damaged by chemotherapy drugs and they stop producing estrogen. Menstrual cycles stop and a woman enters menopause prematurely. Chemo can also cause neuropathy that affects the pelvic nerves in both men and women, causing decreased sensation, difficulty with sexual arousal and problems reaching orgasm.
Chemo isn’t the only culprit responsible for unwanted celibacy after cancer treatment. Physical changes from surgery can cause pain or interfere with your ability to move. Or you may not feel confident about your body after cancer surgery. Tissue damage due to radiation treatments can have similar effects. In addition, many medications, such as anti-depressants, can cause low sex drive and sexual dysfunction.
In the face of such circumstances, what can you do to get your sexy on?
Just as with most things in “cancerland,” nothing can guarantee that your sex life will be exactly the same as it was before your diagnosis. However, by attending to your sexuality, you can decrease pain and discomfort and improve how you feel about your body. This will help you regain intimacy with your partner or have the confidence to meet a new partner.
If you are currently in an intimate relationship, start by telling your partner that you are struggling with sex. This may be the most difficult step. When you show up and say that you are not in the mood, feeling pain during sex or can’t “perform” in some other way, this is a point of maximum emotional vulnerability, but it’s worth it. It’s a starting point for discussion and improvement. You may consider visiting a counselor to help you sort through these topics, either on your own or with your partner. Many of the large cancer centers have counselors and therapists specifically dedicated to sexual health, so ask your oncologist or cancer survivorship treatment team about these services.
Setting the stage for good sex is important—lighting candles, putting on music, giving your partner a massage or whatever else gets you both in the mood. It's also necessary to set aside enough time for intimacy that isn’t sexual: talking, connecting and snuggling. Reconnecting emotionally with your partner doesn’t have to be done right before jumping into bed–in fact, it may work better if you steal small moments of intimacy throughout the week, not just on date night.
In other posts I've talked about the benefits of exercise and it really is true: exercise is beneficial. Studies have shown that for cancer survivors, exercise improves your health in general and your sex life specifically. To boost your libido and your sexual pleasure, keep making an effort to add regular exercise into your routine. Eventually you’ll find types of exercise that fit your level of health and fitness, and the more you exercise the fitter you'll become.
Remember also that even if you don’t have a partner, you can still get busy on your own! Masturbation isn’t mandatory, but it is normal, and you may even learn something about what turns you on. Finally, think about expanding your ideas about what makes for good sexual foreplay, solo sex or the main event.
Sex is deeply personal yet intimately shared. Know that you are not alone if you have cancer and struggle with sexuality. Regardless of how much sex you have, either with or without a partner, be confident that with some investigation, trial and error, and a sense of adventure, you can reclaim your sex life while living with cancer.
Information Resources about Sexuality during and after Cancer Treatment
Center for Intimacy after Cancer Therapy at http://renewintimacy.org/
Information for Men on Sexual Wellbeing after Pelvic Cancer Treatment (booklet), https://www.hse.ie/eng/services/list/5/cancer/profinfo/resources/booklets/pelvic%20cancer.pdf
Michelle Lyons, Pelvic Physiotherapist (Ireland), https://celebratemuliebrity.com/
The North American Menopause Society: http://www.menopause.org/
The Scientific Network for Female Sexual Health and Cancer https://www.cancersexnetwork.org/
Sexual Health and Cancer Treatment: Men, https://www.cancer.net/navigating-cancer-care/dating-sex-and-reproduction/sexual-health-and-cancer-treatment-men
Sexual Wellbeing after Breast or Pelvic Cancer Treatment (booklet), https://www.hse.ie/eng/services/list/5/cancer/patient/leaflets/sexual-wellbeing-after-breast-or-pelvic-cancer-treatment.pdf
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