Keeping your sex life going despite cancer treatment

Here are some points to help your sex life during or after cancer treatment.

Learn as much as you can about the effects your cancer treatment may have on sexuality. Talk with your doctor, nurse, or any other member of your health care team. When you know what to expect, you can plan how you might handle those issues.

Keep in mind that, no matter what kind of cancer treatment you have, you will still be able to feel pleasure from touching. Few cancer treatments (other than those affecting some areas of the brain or spinal cord) damage the nerves and muscles involved in feeling pleasure from touch and reaching orgasm. For example, some types of treatment can damage a man’s ability to have erections. But most men who cannot have erections or produce semen can still have the feeling of orgasm with the right kind of touching. This makes it worthwhile for people with cancer to try sexual touching. Pleasure and satisfaction are possible, even if some aspects of sexuality have changed.

Try to keep an open mind about ways to feel sexual pleasure. Some couples have a narrow view of what is normal sex. If both partners cannot reach orgasm through or during penetration, they feel cheated. But for people treated for cancer, there may be times when intercourse is not possible. Those times can be a chance to learn new ways to give and receive sexual pleasure. You and your partner can help each other reach orgasm through touching and stroking. At times, just cuddling can be pleasure enough. You can also continue to enjoy touching yourself. Do not deny yourself and your partner other ways of showing you care just because your usual routine has been changed.

Try to have clear, 2-way talks about sex with your partner and with your doctor, too. The worst enemy of sexual health is silence. If you are too embarrassed to ask your doctor whether you can have sex, you may never find out. Talk to your doctor about sex and tell your partner what you learn. Otherwise, your partner may be afraid that sex might hurt you. Good communication is the key to adjusting your sexual routine when cancer changes your body. If you feel weak or tired and want your partner to take a more active role in touching you, say so. If some part of your body is tender or sore, you can guide your partner’s touches to create the most pleasure and avoid pain.

Boost your confidence. Remind yourself about your good qualities. If you lose your hair, help yourself to look and feel better by shaving your head with an electric razor. Or try out different kinds of hats to find one you feel comfortable wearing. Eating right and exercising can help keep your body strong and your spirits up. Talk to your doctor or cancer care team about the type of exercise you are planning before you start, or ask to be referred to a physical therapist. Find something that helps you relax – movies, hobbies, getting outdoors. Get professional help if you think you are depressed, or if anxiety is causing problems.

How cancer treatment affects sexual desire and response

These are some general changes in sexual desire and response that may be linked to cancer and cancer treatment. Specific changes linked to certain types of treatment are covered in more detail in the next sections.

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 the list of needs. This is normal. Few people are interested in sex when they feel their lives are in danger. When people are in treatment, worry, depression, nausea, pain, or fatigue may cause loss of desire. 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. Many people who have cancer worry that a partner will be turned off by changes in their bodies or by the very word cancer.

Keep in mind that each part of a man’s sexual cycle is somewhat independent from other parts of the cycle. That is why, after some types of cancer treatment, a man may still desire sex and be able to ejaculate but not have an erection. Other men may have the feeling of orgasm along with the muscles contracting in rhythm, even though semen no longer comes out.

Erection

If a man has a problem getting or keeping an erection, the condition is called impotence or erectile dysfunction (ED). ED becomes more common as men get older, and if they have certain medical problems, such as diabetes, vascular (blood vessel) problems, or stroke.

Cancer treatments can interfere with erection by damaging a man’s pelvic nerves, pelvic blood vessels, or hormone balance. Sometimes these side effects cannot be avoided if the cancer is to be controlled. After cancer treatment, medical or surgical treatments can often restore erections.

Any emotion or thought that keeps a man from feeling excited can also get in the way of getting or keeping an erection. A common anxiety is the nagging fear of not being able to get an erection or satisfy a partner. (See the “When is sexual counseling helpful?” section.)

Premature ejaculation

Premature ejaculation means reaching a climax too quickly. Men who are having erection problems often lose the ability to delay orgasm, so they ejaculate quickly.

Premature ejaculation is a very common problem, even for healthy men. It can be overcome with some practice in slowing down excitement. A few of the newer anti-depressant drugs have the side effect of delaying orgasm. This side effect can be used to help men with premature ejaculation. Some men can also use creams that decrease the sensation in the penis. Talk to your doctor about what kind of help might be right for you.

Pain

Men sometimes feel pain in the genitals during sex. If the prostate gland or urethra is irritated from cancer treatment, ejaculation may be painful. Scar tissue that forms in the abdomen and pelvis after surgery (such as for colon cancer) can cause pain during orgasm, too. Pain in the penis as it becomes erect is less common, but in some men, the penis can develop a painful curve or “knot” with erection. This condition, called Peyronie’s disease, does not seem to be any more common in men with cancer. (Peyronie’s disease is most often due to a scar inside the penis, and may be treated with injections of certain drugs or with surgery.) Tell your doctor right away if you have any pain in your genital area.