The first step in finding help for a sexual problem is to talk to your doctor. He or she may be able to suggest someone who specializes in sexual problems.

Many health care professionals, including doctors, have little training in sexuality issues. They may not be at ease even talking about sex. Many doctors also fail to mention the sexual side effects of cancer or of medical treatments. If they do talk about it, they may give such an unclear picture that you may think that your sex life is over. If your cancer specialist can't help you, we suggest you ask your family doctor or other members of your health care team. If your doctors are not able to help you they should be able to refer you for help. There are many different programs and specialists that can help you find the answers you need.

Sexual rehabilitation programs in cancer centers

A center that specializes in treating cancer may have experts on its staff that can assess and treat sexual problems. But these specialists may see only the patients who are being treated at their hospital. If you are being treated at a cancer center, check to see what programs are offered.

Sexual dysfunction clinics

In recent years, medical schools and even private practice groups have been opening clinics to treat sexual problems. Such clinics provide psychological and medical exams through many different types of health care providers. Some clinics require both sexual partners to take part in the evaluation, but you may be seen alone if you are not in a committed relationship. If there isn't a clinic like this at your hospital, you can call the nearest medical school and ask if they have a sexual dysfunction clinic.

Sex therapists

Sex therapy is a brief type of psychotherapy or counseling (up to 10 or 20 sessions) focused on solving a sexual problem. Sex therapists believe that a person learns lovemaking skills and that bad habits can be corrected by learning different sexual techniques. In between meetings with the therapist, a couple (or sometimes just a man or woman treated alone) is given homework assignments. The homework includes exercises to help you communicate and enjoy touching more. They also help to reduce anxiety that interferes with good sex.

Sex therapists may practice in a clinic or alone. Because most states have no laws regulating the title of sex therapist, people with no formal training can call themselves sex therapists. But a sex therapist should be a mental health professional, such as a psychiatrist, social worker, psychiatric clinical nurse specialist or nurse practitioner, or psychologist. This professional should also have special training in treating sexual problems. Some counselors may provide sexual counseling if a licensed professional supervises them.

It is not always easy to find a well-trained sex therapist. It is even harder if you live far from a city. A professional society, such as the American Association of Sex Educators, Counselors, and Therapists (AASECT), can give you information about their members who have special training in sex therapy. You can also get a listing of sex therapists who practice in your area by contacting your state's Psychological Association, the National Association of Social Workers, or your State Association for Licensed Marriage and Family Therapists. (See the "Additional resources" section for contact information.)

Other kinds of counseling

Sex therapy is not the only kind of counseling that can help a person with cancer. Psychotherapy can allow you to feel better about the changes in your body and help you work through difficult feelings that the cancer diagnosis brought up It can also help you and your partner communicate more clearly and give you skills to better cope with the cancer.

The stress of being diagnosed and treated for cancer can worsen problems that already existed in your relationship. Poor or strained communication with your partner can be discouraging and frustrating. In this case, couples counseling may be helpful if your partner is willing to work with you. Or, individual therapy can help you decide how to best deal with the problem.

Finding a well-qualified mental health professional is important. These are some of the different types of mental health professionals out there:

Psychiatrist: This person has an MD (Doctor of Medicine) degree and has usually completed a hospital residency in psychiatry. He or she should also be certified by the American Board of Psychiatry and Neurology.

Psychologist: Most who are practicing alone have a PhD (Doctor of Philosophy), PsyD (Doctor of Psychology), or EdD (Doctor of Education) degree. Psychologists do not have medical degrees and do not write prescriptions. Psychologists with a master's degree are most often supervised by one with a doctorate. In most states a psychologist must be licensed. Those who practice usually have degrees in clinical or counseling psychology.

Social worker: Social workers usually have masters' degrees in social work (MSW). Again, licensing laws vary from state to state. Some states have a category for licensed psychotherapists called "marriage and family counselors." They usually have masters' degrees in psychology or a related field, plus training in counseling.

Psychiatric clinical nurse specialists or psychiatric nurse practitioners: These nurses have masters' degrees in psychiatric nursing. They are licensed professionally, although their ability to prescribe medicines varies from state to state.

The cost of counseling varies with the professional's training and experience. One way to get quality treatment for a lower fee is to find a nearby medical school with a psychiatry clinic. You can also go to a university that trains clinical psychologists and has a psychology clinic. A student in advanced training will see you, but she or he will be supervised by a senior professional.

You may want to check with your insurance company to find out how much it will reimburse for counseling or therapy.

Other medical specialists

A man with sexual problems may choose to consult a urologist. This is a medical doctor trained in diseases of the urinary tract, including the male genitals. Many urologists perform surgery or prescribe medical treatments for erection problems. They have the special equipment needed to find the cause of an erection problem.

When the most likely cause of a sexual problem is a hormone imbalance, an endocrinologist can be consulted. Endocrinologists are expert in the complex cycles and systems that control hormone levels. Usually your primary doctor is best able to decide if you need the special knowledge of an endocrinologist to solve your problem.

What to avoid

Men and women often seek help for a sexual problem by going to someone who is not really a health care professional. Since sexual problems are so common and so upsetting, many will try unproven remedies or cures. Television, magazines, radio, and the Internet abound with ads for natural enhancers which promise to give you better erections and longer sexual endurance. These heavily marketed and unproven herbs, creams, pills, and supplements have not been studied are not the answer. They are just modern variations on the older methods that are still hawked as cures for sexual problems. There is no evidence that any of them work, either: not the many herbal potency pills on the market nor other approaches like "poppers," "Spanish fly," oysters, splints around the outside of the penis to stiffen it, muscle exercises that claim to enlarge a man's penis, hypnotism by someone not trained as a mental health professional, or visits to an independent "sexual surrogate." Not only do these treatments not work, they can sometimes be harmful.

Looking ahead

Sexuality is an important part of everyday life. Talk to someone on your health care team if you are having problems or concerns about sex. We hope this information will help you if you do need to talk over a sexual problem. We also hope that it will help to enrich your life and help you and your partner to remain close.

About the American Cancer Society

The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and service.

The American Cancer Society offers up-to-date cancer information, educational programs, services, and referrals. Check your telephone directory for your local American Cancer Society office or call 1-800-ACS-2345 (1-800-227-2345).

I Can Cope®

This program addresses the educational and psychological needs of people with cancer and their families. These classes discuss the disease and provide information on local resources. In this series, you will learn how to cope with daily health problems, express feelings, and live with the limitations that cancer presents. Through lectures, group discussions, and study assignments, the course helps people with cancer regain a sense of control over their lives. Contact 1-800-ACS-2345 or your local American Cancer Society office for more information.

Man to Man®

Man to Man provides accurate, factual information for men and their partners about prostate cancer in a supportive environment following essential guidelines that assure program integrity and credibility. Man to Man is an ideal vehicle by which new relationships are formed between patients/survivors and care providers with a two-way exchange of information, trust, and respect. The partnership of the American Cancer Society with volunteer health professionals and survivors has proved to be an exciting and valued service for all involved.

Last Medical Review: 02/02/2009
Last Revised: 02/02/2009