SEX 101
It is important to understand the components of sexual response to know how treatment does (or does not) affect each part. There are four parts to a healthy sexual response. They are desire, excitement, orgasm, and resolution. Desire and excitement are the parts of a woman’s response that are most commonly affected.
Desire
Desire, or libido, refers to an interest in sex. Your desire can be affected by many things. For example, your relationship with your partner could affect it. So could stress or fatigue. Lack of estrogen and testosterone because your ovaries were removed can also affect desire.
Natural menopause occurs when a woman no longer has her periods. It may decrease a woman’s desire if there is no estrogen replacement. Both chemotherapy and radiation can affect the way ovaries function. In women over 40, this can lead to early menopause. Treatments such as chemotherapy and radiation have side effects. Some can decrease the desire for sex.
Excitement
Excitement is your body’s response to desire. It causes more blood to flow to the vagina. This, in turn, causes the vagina to get larger. It also produces moisture and lubrication. Without ovarian function and without estrogen replacement, the vagina thins. This reduces its ability to stretch. The condition is called, "vaginal atrophy." It can cause discomfort during intercourse. It can also cause itching or burning in the vagina.
Orgasm
Orgasm is the sexual climax. Most cancer treatments do not affect orgasms. In rare cases, though, surgical manipulation of the nerves leading to the clitoris can have an effect. This might happen, for instance, with vulva cancer involving the clitoris.
The uterus contracts during orgasm. Some women say orgasms are less intense after a hysterectomy. Other women, though, say there is no change.
Resolution
Resolution is the return to the unexcited state. This is not a usual concern for women with gynecological cancers.