Sexuality and Intimacy: The Mind – Body Effect

Being diagnosed with a gynecologic cancer can affect the physical, emotional, spiritual, and sexual aspects of a woman's life. Having cancer can also affect a woman's intimate and sexual relationships. If you have cancer, you have to deal with many changes. Over time, who you are, how you feel about yourself, and the nature of your relationships may all change. Physical changes will drive emotional changes and the alter your normal response to every day events and requests. Fear of the unknown or poor understanding of what is “normal” changes during treatment can make it more difficult to be healthy during cancer treatment. Reassurance and education can make a huge difference in how you perceive yourself through cancer treatment and afterwards.

Outlined below are some of the ways cancer may affect your sexuality and will give you some of the facts about what is “normal” during treatment and recovery.

Communication

You may find it hard to talk to your health care provider about sexuality. It may be hard to even bring the topic up or you may feel that your doctor is too rushed to have a talk about this perceived sensitive subject. Many people think conversations about sex should be kept private. But sex is an important part of many people’s quality of life. And changes in sexual feelings, desires, and function do matter and should be talked about.

You need to have trust before you feel comfortable talking about sexuality and intimacy and the changes that may occur. And it is important to remember there is no ‘standard’ sexual practice that works for everyone. What some people view as ‘normal and healthy’ others may view as ‘disgusting or unappealing.’ What does matter, though, is that you and your partner share the same values and pleasures.

How you talk about sexual concerns with your health care team depends on where you are in your relationship with your partner. If you’re married, you may have different concerns than if you are single. If you’re single, you may withdraw from dating for fear of being rejected. If you’re gay you may not feel comfortable talking about sexual preference with your health care team. What you do need to do is find a team member you are most comfortable talking to. That could be the doctor or nurse, social worker or a cancer counselor It could be any provider in the cancer team.

When you think about how cancer may have affected your sexuality, ask yourself the following questions:

  • How has my illness changed the way I see myself and feel about myself?
  • How has my illness interfered with my role as partner or mother?
  • How has my illness affected my sexual functioning or response?

It’s also important to talk with your partner about sexuality and intimacy. You each have your own fears and questions. And if you don’t have a partner, it’s still important to consider how your cancer might affect your future relationships.

“Normal” Changes During Cancer Treatment and Tips for Coping

Many changes take place with cancer treatment that can affect your sexuality. They may be short-term and only temporary. Or they may last a long time. Different treatments can affect how you feel, look, and function. Side-effects of treatment can cause:

  • changes in body image, such as hair loss
  • weight changes
  • menopause
  • fatigue
  • pain
  • anxiety

After cancer treatment, you may experience:

  • less sexual desire
  • vaginal dryness
  • shortening or narrowing of the vagina
  • painful intercourse
  • trouble reaching orgasm
  • infertility

All of these changes can affect your sexuality. They can affect your sexual ability and your interest in sexual activity. Sexuality refers to more than just sexual intercourse. It refers to other means of sexual expression, such as touching and kissing. Intimacy refers to the physical or emotional closeness you share with another individual. Self-esteem and body image play a role in defining how you feel about yourself.

Whether the changes are temporary or long lasting, you can find ways to feel good about yourself and to be intimate with your partner. It’s important to remember to be patient and give yourself time. Here are some tips to help you cope with these changes:

  • Focus on physical recovery, including diet and physical activities.
  • Talk to your doctor or nurse about maintaining or resuming sexual activity.
  • Include your partner in discussions.
  • Report vaginal discharge or bleeding, fever, or pain to your doctor or nurse.
  • Choose a time for intimacy when you and your partner are rested and free from distractions.
  • Create a romantic mood.
  • Try different positions until you find one that is more comfortable and less tiring for you.
  • Rediscover your body’s pleasure zones. You can do this alone, or with your partner. Find what part of your body feels stimulated by touch, starting from head to toes.
  • Use pillows for comfort.
  • Use a water-soluble lubricant (Astroglide, K-Y jelly, Lubrin), if needed for intercourse.
  • Use dim lights, wigs, lingerie, and other things to cover wounds or scars if body image concerns keep you from being intimate.
  • If pain symptoms or nausea prevents you from being intimate, take medications 30-60 minutes before being emotionally close.
  • Remember that cancer is not contagious.
  • Use birth control during cancer treatment if needed.
  • Remember that being intimate will not cause the cancer to come back or grow.
  • Remember that your partner is also affected by your cancer. So talk about both your and your partner’s feelings and fears.
  • Explore different ways of showing love — hugging and holding, stroking and caressing, talking.
  • Discuss treatment options with your health care team if you have menopausal symptoms because of therapy.
  • Find humor where you can.

Sexuality Questions — Ask the Doctor

Patients are often overwhelmed with the information they receive from their doctor. It is important that you take the time to gather as much information as possible. Here are some questions to ask your doctor or other health care provider.

  • How will my cancer and its treatment affect my desire for sex and my sexual function?
  • How long will these changes last?
  • What can I do about them?
  • Will I cause harm to myself or to my partner if I have sex?
  • Are there any restrictions that I should be aware of?