Sexuality Issues and Cancer

This information was provided by the Gynecologic Cancer Foundation. www.thegcf.org

Sexuality Questions

  • How will my cancer and its treatment affect my desire for sex and my sexual function?
  • How long will these changes last?
  • What can I do about them?
  • Will I cause harm to myself or to my partner if I have sex?
  • Are there any restrictions that I should be aware of?

Being diagnosed with a gynecologic cancer can affect the physical, emotional, spiritual, and sexual aspects of a woman's life. Having cancer can also affect a woman's intimate and/or sexual relationships. Women with cancer have to deal with many changes in their lives. Over time, who they are, how they feel about themselves, and their relationships may all change as a result of the cancer. Some of the changes women with cancer may have related to their sexuality are outlined below.

Communication

Women often find it hard to talk to their health care provider about changes in sexual feelings, desires, and function. However, sex is an important part of many people’s quality of life. Bringing up the topic of sex may be hard because many people think sexuality is a private means of conversation.

Communication and trust are needed for women with cancer to feel comfortable talking about sexuality and intimacy and the changes that may occur. It is important to remember that there is no ‘standard’ sexual practice that works for everyone. What some people view as ‘normal and healthy’ others may view as ‘disgusting or unappealing.’ What does matter is that the patient and her partner share the same values and pleasures. Talking about sexual concerns with the health care team depends on where the couple is in a relationship. A married woman may have different concerns than a single woman. A gay woman may not be comfortable talking about her sexual preference with her health care team. All woman need to find a team member they are most comfortable talking to, whether it is the doctor, nurse, or social worker.

When thinking about the effects cancer may have had on a woman's sexuality, she may want to ask herself the following questions:

1. How has my illness changed the way I see myself and feel about myself?

2. How has my illness interfered with my role as a partner or mother or...?

3. How has my illness affected my sexual functioning or response?

Partners should also talk about sexuality and intimacy because of their own fears and questions. Even if a woman with cancer does not have a partner, she may still want to know how the cancer will possibly affect her future relationships.

Changes

Many short- and long-term changes take place with cancer treatment that may affect a woman’s sexuality. They may be temporary, or they may last a long time. The effects of different treatments can change how a woman feels, looks, and functions. Changes in body image such as hair loss, weight changes, menopause, fatigue, pain, and anxiety are some side effects women may have. A woman, who has had cancer treatment, may experience low sexual desire, vaginal dryness, vaginal shortening or narrowing, painful intercourse, trouble reaching orgasm, and infertility. All of these changes can affect a woman's sexuality and her ability and interest in sexual activity. Sexuality not only refers to sexual intercourse, but other means of sexual expression, such as touching and kissing. Intimacy refers to the physical or emotional closeness shared with another individual. Self-esteem and body image are important factors that define how a woman feels about herself.

Whether the changes are short-term or long lasting, a woman can find ways to feel good about herself and to be intimate with her partner. It is important that she remember to be patient and give herself time. Below are some ideas to help women cope with these changes:

  • Focus on physical recovery, including diet and physical activities
  • Ask your doctor or nurse about maintaining or resuming sexual activity
  • Include your partner in discussions
  • Report vaginal discharge or bleeding, fever, or pain to your doctor or nurse
  • Choose a time for intimacy when you and your partner are rested and free from distractions
  • Create a romantic mood
  • Try different positions until you find one that is more comfortable and less tiring for you
  • Use pillows for comfort
  • Use a water-soluble lubricant (Astroglide, K-Y jelly, Lubrin), if needed for intercourse
  • Use dim lights, wigs, lingerie, and other things to cover wounds or scars if body image concerns keep you from been intimate
  • If pain symptoms or nausea prevents you from being intimate, take medications 30-60 minutes before emotional closeness
  • Remember that cancer is not contagious
  • Use birth control during cancer treatment if needed
  • Remember that being intimate will not cause the cancer to come back or grow
  • Remember that your partner is also affected by your cancer, so talk about both of your feelings and fears
  • Explore different ways of showing love (hugging and holding, stroking and caressing, talking)
  • Discuss treatment options with your health care team if you have menopausal symptoms because of therapy
  • Find humor where you can