Sexuality Issues

Women with vulvar cancer have to deal with many changes in their lives. Over time, who they are, how they feel about themselves, and their relationships may all change as a result of the cancer. Some of the changes women with cancer may have related to their sexuality are outlined below. Some ideas are shared on how to deal with those changes, and some resources are listed at the end.

Many women feel awkward talking about sexual issues and might find it hard to be honest about how they feel. A woman's partner, doctor, or nurse may wait for her to bring up the subject of sex, because they do not want to make her feel uncomfortable. Women should feel free to ask questions and talk about their sexual issues or concerns. It might be helpful to talk to social workers, counselors, or other women in support groups.

When thinking about the effects cancer may have had on a woman's sexuality, she may want to ask herself 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 or...?
  • How has my illness affected my sexual functioning or response?

Changes

Many short- and long-term changes take place with cancer treatment that may affect a woman’s sexuality. They may be temporary, or they may last a long time. The effects of different treatments can change how a woman feels, looks, and functions. Changes in body image such as hair loss, weight changes, menopause, fatigue, pain, and anxiety are some side effects women may have. A woman, who has had cancer treatment, may experience low sexual desire, vaginal dryness, vaginal shortening or narrowing, painful intercourse, trouble reaching orgasm, and infertility. All of these changes can affect a woman's sexuality and her ability and interest in sexual activity.

Sexuality not only refers to sexual intercourse, but other means of sexual expression, such as touching and kissing. Intimacy refers to the physical or emotional closeness shared with another individual. Self-esteem and body image are important factors that define how a woman feels about herself.

Whether the changes are short-term or long lasting, a woman can find ways to feel good about herself and to be intimate with her partner. It is important that she remember to be patient and give herself time. Below are some ideas to help women cope with these changes:

  • Focus on physical recovery, including diet and physical activities
  • Ask 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
  • 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 been intimate
  • If pain symptoms or nausea prevents you from being intimate, take medications 30-60 minutes before emotional closeness
  • 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 of your 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

Patients are often overwhelmed with the information they receive from their doctor. Below are some questions to ask the doctor.

Sexuality Questions

  • 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?