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Lack of desire
Both men and women often lose interest in sex during cancer
treatment, at least for a time. At first, concern for survival is so
great that sex is far down on your list of needs. This is quite normal.
Few people are interested in sex when they feel their lives are being
threatened.
When people are in treatment, loss of desire may result from worry,
depression, nausea, pain, or fatigue.
Cancer treatments that disturb the normal hormone balance can
also lessen sexual desire.
If there is a conflict in the relationship, one partner or both might
lose interest in sex.
Any emotion or thought that keeps a woman from feeling excited can
interfere with desire for sex. Distracting thoughts can keep her from
getting aroused. Her vagina then stays tight and dry, which can make
intercourse painful.
Many people who have cancer worry that a partner will be
turned off by changes in their bodies or by the very word "cancer."
These worries can affect desire.
Pain
Pain is a common problem for women during intercourse. It is
often related to changes in the vagina's size or moistness. These
changes can happen after pelvic surgery, radiation therapy, menopause,
or treatment that has affected a woman's hormones.
Sometimes the pain sets off a problem called vaginismus. If a
woman has vaginismus, the muscles around the opening of the vagina
become tense without the woman being aware of it. Her partner cannot
enter the vagina. Pushing harder increases the woman's pain because her
vaginal muscles are clenched in a spasm. Vaginismus can be treated with
counseling and some special relaxation training. These treatments are
described in the section, "Ways of dealing with sexual problems."
Premature menopause
Another common way that cancer treatment can affect a women's
sex life is by causing menopause earlier than normal. This is called
premature menopause. Symptoms are often more severe than the slow
changes that happen during a natural menopause. When a woman's ovaries
are removed as part of a cancer surgery, or when the ovaries are
affected by chemotherapy or radiation to the pelvis, the loss of
estrogen can trigger hot flashes and vaginal atrophy (a condition when
the vagina becomes tight and dry). Some women can take replacement
hormones or use other methods to help these problems. Women with
cancers of the breast or uterus usually cannot take estrogen, but they
may benefit from some of the suggestions in the section, "Ways
of dealing with sexual problems."
Women who have premature menopause sometimes have low androgen
levels, which can lower sexual desire and pleasure. A blood test can
find this problem. Often replacement androgen hormones can safely be
prescribed.
If you are thinking of using hormones, it is wise to talk with
your doctor or nurse to learn about the benefits and possible risks of
hormonal therapy.
Orgasm
Women are usually able to have orgasms after cancer unless
cancer or its treatment has damaged the spinal cord and caused the
genital area to be numb. But even with spinal cord damage, there is
early evidence that orgasm is possible, at least in some women.
Sometimes problems like pain during intercourse may distract a
woman from reaching orgasm. In some cases, a woman might need to try
different positions or types of genital touching. She might also need
to practice having orgasms alone before going back to sex with a
partner. (If you have had surgery for cancer in the pelvis or genital
area, see the next section.)
Last Medical Review: 11/10/2008
Last Revised: 11/10/2008
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