Sexuality for the Woman With Cancer

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Chemotherapy changes the way you look

The most obvious change caused by chemo will likely be hair loss. You may expect to lose the hair on your head, but other body hair, such as eyebrows, eyelashes, and pubic hair, are often affected, too. You may also lose weight and muscle mass if you have trouble eating. On the other hand, many women gain weight during or after chemo. Your skin may get darker, become dry and flaky, or you may be very pale. Your nails may become discolored or ridged. And you may also have an infusion (IV) catheter or port placed in your chest or arm or abdomen (belly).

Some physical changes caused by chemo can be covered up or made less obvious. If you are just starting chemo, you may want to shop for a wig before your hair begins to fall out. If you have very long hair, you may even be able to have it cut off and made into a wig. This is costly, but some people find it worthwhile. Wigs are warm and often not comfortable, so you may decide to mostly wear your wig outside the home or hospital. You can also use scarves, turbans, hats, or caps. Some women leave their heads uncovered. Still others switch back and forth, depending on whether they are in public or at home with family and friends.

It’s a good idea for a couple to discuss how each feels about wearing a wig or head covering during sex. There’s no right or wrong decision.

Disguising weight loss, skin color and nail changes, and infusion catheters is a bigger problem. For the most part, clothes that fit well look better. Wearing something too tight or too baggy will draw attention to your weight change. High necks and long sleeves can hide a catheter, but may be too hot in warm weather. Look for thin fabrics that will be cool while covering you.

Sometimes the changes in your body are so upsetting that you can’t relax or think positively. Rather than feeling distressed or disappointed, take this as a sign that some counseling from a health care professional may be helpful. (See the section called “Professional help” for more information.)

Ways to cope with changes in how you look

Feeling good about yourself begins with focusing on your positive features. Talk to your doctor about things that can be done to limit the damage cancer can do to your appearance, your energy, and your sense of well-being. When you are going through cancer treatment, you can feel more attractive by disguising the changes cancer has made and drawing attention to your best points.

This mirror exercise can help you adjust to body changes:

  • What do you see when you look at yourself in the mirror? Many people notice only what they dislike about their looks. When they look in the mirror, they see pale skin, hair loss, an ostomy, or skinny legs. They fail to see a classic profile, expressive eyes, or a nice smile.
  • Find a time when you have privacy for at least 15 minutes. Be sure to take enough time to really think about how you look. Study yourself for that whole time, using the largest mirror you have. What parts of your body do you look at most? What do you avoid seeing? Do you catch yourself having negative thoughts about the way you look? What are your best features? Has cancer or its treatment changed the way you look?
  • First, try the mirror exercise when dressed. If you normally wear clothing or special accessories to disguise changes from cancer therapy, wear them during the mirror exercise. Practice this 2 or 3 times, or until you can look in the mirror and see at least 3 positive things about your looks.
  • Once you are comfortable seeing yourself as a stranger might see you, try the mirror exercise when dressed as you would like to look for your partner. If you’ve had an ostomy, for example, wear a bathrobe or teddy you like. Look at yourself for a few minutes, repeating the steps in the first mirror exercise. What is most attractive and sexy about you? Pay yourself at least 3 compliments on how you look.
  • Finally, try the mirror exercise in the nude, without disguising any changes made by the cancer. If you have trouble looking at a scar, bare scalp, or an ostomy, take enough time to get used to looking at the area. Most changes are not nearly as ugly as they seem at first. If you feel tense while looking at yourself, take a deep breath and try to let all your muscles relax as you exhale. Don’t stop the exercise until you have found 3 positive features, or at least remember the 3 compliments you paid yourself before.

The mirror exercise may also help you feel more relaxed when your partner looks at you. Ask your partner to tell you some of the things that are enjoyable about the way you look or feel to the touch. Explain that these positive responses will help you feel better about yourself. Remember them when you are feeling unsure.

Last Medical Review: 08/29/2013
Last Revised: 08/29/2013