Healthy Sexuality After Cancer

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How do I reclaim my sexual self after cancer treatment?

Sexuality, including sexual function and the psychological aspects of sexual health, are affected in almost everyone who goes through cancer treatment. The diagnosis & treatment of cancer often result in profound changes for both the person with cancer, and her or his friends and family. While your health care provider may not have prepared you for these changes, they are real and no less important than the other changes you’re experiencing. There are many ways that you can work with your mind, your body, and your partner to address these changes so that you can enjoy healthy, rewarding intimacy after cancer treatment.

Expect that your body’s response to arousal and stimulation will have changed.
Cancer treatment will change nerve function and blood flow, both of which are critical components of sexual arousal and pleasure. Surgery, chemo and radiation literally change your body, and many people experience a negative shift in their body image in addition to the changes in function that may result from therapies and treatment.

Grieve changes as often as you need to

An event as profound as cancer produces many changes, and it is important to be able to acknowledge these changes, grieve the way that they have altered your perceptions and experiences, and then allow yourself to move forward into the way that your body and mind function now. So you will want to take time and grieve:

  • changes in how your body feels & functions,
  • changes in your energy, and
  • changes in your desire, arousal and sensation.

Let go of how you were, and embrace how you are now.

Reconnect with your body

When you go through cancer treatment, it is common to “check out” of your body so that you can tolerate all the poking, prodding, testing, and evaluation. This is called dissociation, and it will persist even after treatment ends if you don’t do things that help to reunite your conscious mind and body. Without that mind-body connection, it’s much harder to feel pleasurable touch and enjoy intimacy.

Ways to re-integrate your mind & body so that you can enjoy sensual and sexual pleasure include:

  • Get a manicure or pedicure.
  • Find a massage therapist who specializes in people living with cancer and get a full-body massage. Expect to cry or feel intense emotion as you re-integrate mind & body.
  • Move, breathe and eat mindfully, noticing every sensation as you do it.
  • Connect consciously with the things you love about your body.
  • Find clothing or lingerie that is comfortable and makes you feel sexy and attractive.
  • Learn what feels good now and what kind of touch works best for you.
  • Do something physical (yoga, biking, walking, paddling, sitting in the sunshine) and focus on how your body feels as you do it.

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 Communicate with your partner

Sometimes it takes something as life-altering as cancer to help one realize how important it is to have clear and loving communication in order to keep intimate relationships healthy. You may have had the skills before cancer, but the stress and trauma of diagnosis and treatment may result in forgetting how to take the time to talk, listen, and intentionally move through life together as a team. Partners are often afraid to touch the cancer survivor for fear of hurting her or him, and may not really know what she or he is feeling or thinking after treatment, nor know how to ask. Take the time and do some work to make sure that you’re both fully communicating with each other.

  • Grieve the changes together.
  • Help your partner get to know your body as it is now.
  • Ask what s/he loves about you, mind, body and spirit.
  • Move forward together and further develop your sense of being a team in this life.
  • Make time for intimate closeness if you don’t have the energy for sex.

Cancer treatment can leave you with less energy than before, and it can take a long while for your body to recalibrate and (hopefully) regain its energy and vitality. Take some time with your partner to cuddle, touch, and be close in intimate, but not necessarily sexual, ways when you don’t have energy for sex. This will keep your bond strong, and provide healing touch and comfort for both of you.

Support your partner’s need for sexual release with permission to self-pleasure at times when you don’t feel like having sex with him/her.

If you are feeling less sexual than your partner, it’s important to give your partner permission to enjoy self-pleasure as a part of him or her life. It is not your responsibility to provide sexual opportunities or release for your partner, but it is helpful for you to explicitly give permission for her or him to maintain their own wellness through orgasm and self-pleasure. One way to provide this kind of permission is to give your partner a pleasure toy, or an erotic book or dvd, with instructions to “enjoy yourself, with love…” There will be a time when you will want to explore your own pleasure, alone, as you learn how your body has changed and what feels good now, so setting the stage early for healthy self-pleasure can make that more comfortable when it’s your turn.

Get to know your “new normal”

Because cancer treatment changes how your body responds to touch and stimulation, once you’re through treatment and feeling reunited with your body, it is time for you to explore to see how it works, what feels good, what is not-so-pleasurable, and what kind of touch and mental stimulation work best for sexual arousal and sensation.

  • How does arousal work in your body now?
  • What turns you on mentally? Physically?
  • When do you have the energy for sex?
  • If you have pain or discomfort, what do you need to accommodate that?
  • What does it take to have an orgasm now?
  • Take time to explore with yourself so you can share what you learn with your partner.
  • Create a pleasure map for your partner (and have him/her do the same for you) showing what kind of touch you like and where, and showing where the “no go” zones are now.

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Practice communicating and negotiating around sex

It’s always a good idea to be able to communicate explicitly about what you like and want; after cancer it is even more important to do so. Practice asking for what you want, planning together to enjoy intimacy at times when you have the most energy and interest, and make conscious “sex dates” so intimate play doesn’t get left out of your life altogether.

Explore new ways to make love

It won’t be the same as it was before, and with some creativity and learning, it can be even better and more intimate than before the cancer.

  • Pleasure each other without having intercourse. For ideas, see the AWT Othercourse brochure. Enjoy the sensations. Take your time. Be less goal-oriented.
Get creative and experiment with new positions and places.
  • Use tools and enhancements when you need them
  • Lubricant
  • Vibrator for helping with arousal, sensation and orgasm
  • Vibrating Massage Wand for vaginal health and renewal
  • Kegel Exerciser to help keep your pelvic floor strong and flexible
  • Penile Rehabilitation devices for erectile dysfunction after pelvic cancer treatment or surgery
  • Woman Cancer Sex (book) by Anne Katz RN
  • Man Cancer Sex (book) by Anne Katz RN

Ask for professional help from a therapist (relationship or sex therapy) if you need it

Sometimes it’s just too hard to deal with it all on your own pace. Find someone you’re comfortable working with and ask for the help you need, as an individual or as a couple.
Remember to take time for pleasure and intimacy, and know that while things will not be the same as they were, they may be even better!

Keep yourself sexually and physically healthy

Eat a Good Sex Diet:

  • Lots of fruits & vegetables
Fish & Fish oil
  • Whole grains
  • Lean meats
  • Olive, avocado and fish oils
  • Dark Chocolate
  • For more information, see the AWT Good Sex Diet brochure.

Exercise as you have the energy:

  • Walk (or bike or swim) 30 minutes per day when possible
  • Stretch daily
  • Do light strength training if you can

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