Sexuality for the Man With Cancer

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Professional help

The first step in finding help for a sexual problem is to talk to your doctor. 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 and medical treatments. If they do talk about it, they might give you 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 another member of your health care team. If your doctors are not able to help you, they should be able and willing 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’re being treated at a cancer center, check to see what programs are offered.

Sexual medicine clinics

In recent years, medical schools and even private practice groups have been opening to treat sexual problems or promote sexual health. Such clinics provide psychological and medical exams through many different types of health care providers. Some clinics require both sexual partners to take part, but you may be seen alone if you’re not in a committed relationship. You can try calling a nearby medical school and ask if they have a sexual medicine clinic or sexual health program.

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 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 includes exercises to help you communicate and enjoy touching more. They also help reduce anxiety that often interferes with good sex.

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

It’s not always easy to find a well-trained sex therapist. It’s 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 professionals in your area by contacting your state’s psychological association, a chapter of the National Association of Social Workers (NASW), or a state association for licensed marriage and family therapists. (See the “To learn more” 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 help you feel better about the changes in your body, help you and your partner communicate more clearly, and give you skills to better cope with the cancer and cancer treatment.

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. Individual therapy can also 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 a medical degree with a specialty in psychiatry. They should also be certified by the American Board of Psychiatry and Neurology.

    Psychologist: Most who are practicing alone have a doctorate in psychology (PhD or PsyD) or in education (EdD). Psychologists do not have medical degrees and don’t 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: A social worker usually has master’s degree in social work (MSW). Licensing laws vary from state to state. 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: These nurses have a master’s degree 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, and your health insurance companies reimburse at different rates. 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 they will be supervised by a senior professional.

You may want to check with your insurance company to find out if it will pay (and how much it will cover) for counseling or therapy.

Other medical specialists

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

When the most likely cause of a sexual problem is a hormone imbalance, an endocrinologist should 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’s not really a health care professional. Sexual problems are common and upsetting, and many people will try unproven remedies or cures. Television, magazines, radio, and the Internet abound with ads for natural enhancers that promise to give you better erections and longer sexual endurance. These heavily marketed and unproven herbs, creams, pills, and supplements have not been studied and are not the answer. There’s no evidence that any of them work: not the herbal potency pills like “poppers” or “Spanish fly,” oysters, splints around the outside of the penis to stiffen it, muscle exercises that claim to make a man’s penis bigger, hypnotism by someone not trained as a mental health professional, or visits to an independent “sexual surrogate.” These treatments do not work and can sometimes be harmful.

Last Medical Review: 08/19/2013
Last Revised: 08/19/2013