Intimacy and Sexuality
You may have changes in your sex life after cancer treatment — many people do. Depending on the cancer you had, these problems may be short-term or longterm. About half of women who have had long-term treatment for breast and reproductive organ cancers and more than half of men treated for prostate cancer report long-term sexual problems. Many cancer survivors say they were not prepared for the changes in their sex lives.
Sexual problems after cancer treatment are often caused by changes to your body — from surgery, chemotherapy, or radiation, or by the effects of pain medicine. Sometimes emotional issues can be the cause of sexual problems. Some examples include anxiety, depression, feelings of guilt about how you got cancer, changes in body image after surgery, and stress between you and your partner. Your past sex life is not related to your current sexual problems.
What types of problems occur? People report four main concerns:
Getting Help With Sexual Problems From Your Doctor or Nurse
Worry about intimacy after treatment. Some may struggle with their body image after treatment. Even thinking about being seen without clothes may be stressful. People may worry that having sex will hurt or that they won't be able to perform or will feel less attractive. Pain, loss of interest, depression, or cancer medicines can also affect sex drive.
Not being able to have sex as you did before. Some cancer treatments cause changes in sex organs that also change your sex life.
- Some men can no longer get or keep an erection after treatment for prostate cancer, cancer of the penis, or cancer of the testes. Some treatments can also weaken a man's orgasm or make it dry.
- Some women find it harder, or even painful, to have sex after cancer treatment. Some cancer treatments can cause these problems; sometimes, there is no clear cause. Some women also have a loss of sensation in their genital area.
Having menopause symptoms. When women stop getting their periods, they can have hot flashes, dryness or tightness in the vagina, and/or other problems that can affect their desire to have sex.
Losing the ability to have children. Some cancer treatments can cause infertility, making it impossible for cancer survivors to have children. Depending on the type of treatment you had, your sex and age, and the length of time you've been out of treatment, you may still be able to have children.
Your doctor may be able to help you deal with these problems, but he or she may not bring up the subject. You may need to mention it yourself. If you think you might have trouble getting started, bring this document with you and show this section to your doctor or nurse.
Often, sexual problems will not get better on their own. To get help with many of these problems, it is important to tell your doctor about any changes in your sex life. Sometimes there can be an underlying medical problem that causes changes, such as:
Erection problems. Medicine, assitive devices, counseling, surgery, or other approaches may help.
Vaginal dryness. Dryness or tightness in the vagina, which can be caused by menopause. Ask whether using a water-based lubricant during sex, using vaginal dilators before sex, and/or taking hormones or using a hormone cream are options for you.
Muscle weakness. You can help strengthen muscles in your genital area by doing Kegel exercises. Practice by controlling your muscles to stop the flow of urine. You can do these exercises even when you are not urinating. Just tighten and relax the muscles as you sit, stand, or go about your day.
Other issues you may want to discuss include:
Tips: Feeling Intimate After Treatment
- Concerns about having children. Discuss family planning concerns with your doctor. If you are a woman, ask if you still need to use birth control even if you are not getting your period.
- Talking with a counselor or psychologist. You may feel that some of your sexual problems are due to your emotions, like stress or body image. Some people find that sexual problems related to cancer start to strain their relationship with their partner. If this is the case, ask a nurse or social worker if you can talk to a counselor. Talking to someone alone, or with your partner, may help.
- Seeing a sex therapist. He or she may be able to help you talk openly about your problems, work through your concerns, and come up with new ways to help you and your partner.
Most people can still enjoy sex and intimacy after cancer treatment, even if they need to make changes. Here are some ideas that have helped other people.
Be proud of your body. It got you through treatment.
Think of things that help you feel more attractive and confident.
Focus on the positive. Try to be aware of your thoughts, since they can affect your sex life.
Touch each other. Kiss, hug, and cuddle even when you cannot have the kind of sex you are used to having.
Be open to change. You may find new ways to enjoy intimacy.
Aetna Members: If you would like more information about breast cancer and breast cancer prevention, please call (888) 322-8742.
Miembros de Aetna: Si desean mayor información sobre el cáncer de seno y sobre su prevención por favor llame al (888) 322-8742.