The first step in finding help for a sexual problem is to discuss it with your doctor. Ideally, he or she can suggest a specialist in sexual problems.

Many health care professionals, including some doctors, have little training in sexual issues. They may not be at ease even talking about sex. Doctors may fail to mention the sexual side effects of cancer or of medical treatments. Also they may provide such a sketchy 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 another member of your health care team. If your doctors are not able to give you a referral, a number of different programs and specialists can often help.

Sexual rehabilitation programs in cancer centers: A center that specializes in treating cancer may have experts on staff that can assess and treat sexual problems. However, these specialists may see patients who are being treated for cancer 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 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 participate in the evaluation, though you may be seen alone if you are not in a committed relationship. You can also 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 to 20 sessions) focused on solving a sexual problem. Sex therapists believe that lovemaking skills are learned and that bad habits can be corrected by learning different sexual techniques. In between meetings with the therapist, a couple (or sometimes just one partner) is given homework assignments. The homework consists of exercises to develop better communication and more enjoyment of touching. It also reduces anxiety that interferes with good sex.

Sex therapists may practice in a clinic or independently. Because most states have no laws regulating the title "sex therapist," a person with no formal training can call themselves sex therapists. A sex therapist, however, should be a mental health professional (psychiatrist, social worker, or psychologist) with special training in treating sexual problems with sex therapy. 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 specific training in sex therapy. You can also get a listing of professionals in your by contacting your state’s psychological association, a chapter office for the National Association of Social Workers (NASW), or a state association for licensed marriage and family therapists.

Other Kinds of Counseling

Sex therapy is not the only kind of counseling that can be helpful to a person with cancer. Psychotherapy can allow you to feel better about the changes in your body, help improve communication in your relationship, and give you skills to better cope more easily with the cancer.

Finding a well-qualified mental health professional is important. A psychiatrist has a Doctor of Medicine (MD) 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.

Most psychologists practicing independently have a Doctor of Philosophy (PhD) degree, or sometimes a Doctor of Psychology (PsyD) or Doctor of Education (EdD) degree. Psychologists with a master's degree most often work under the supervision of one with a doctorate. In most states, a psychologist must be licensed. Those who practice usually have their degree in clinical or counseling psychology.

Social workers usually have a master's degree in social work (MSW). Some states have a category for licensed psychotherapists called marriage and family counselors. They usually have a master's degree in psychology or a related field, plus training in counseling.

Psychiatric clinical nurse specialists or psychiatric nurse practitioners have a master's degree in psychiatric nursing. They are licensed professionally, although their ability to practice independently also varies state to state.

The expense of counseling varies with the professional’s training. 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. You will be seen by a student in advanced training, but she or he will be supervised by a senior professional.

Other Medical Specialists

A woman with sexual problems should be examined by a gynecologist, a medical doctor trained in diseases of the female genitals and reproductive organs. A thorough and gentle pelvic exam is very important when a woman has pain during intercourse.

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

What to Avoid

Unfortunately, men and women seeking help for a sexual problem often go to someone who is not really a health care professional. Sexual problems are so common and upsetting that many will try unproven remedies or cures. Although there is no evidence that any of the following can cure a sexual problem, they are often said to be cures: potency pills (such as "poppers" or "Spanish fly"), oysters, "exercisers" that fit inside a woman's vagina, hypnotism by someone not trained as a mental health professional, or visits to an independent "sexual surrogate." Pursuing such treatments not only wastes your time and money but can sometimes be harmful.

Looking Ahead

Sexuality is an important part of everyday life and cancer can alter your sexuality. We hope this information will help to enrich your life and enable you and your partner to remain close.

Revision date: 12/21/2006