Sexuality and Intimacy After Cancer

At Rocky Mountain Cancer Centers, we understand that moving forward after cancer treatment isn’t easy. In fact, for many patients, it will require some adjustments. Rather than worrying about cancer, there will be new concerns, which may include going back to work, reminding yourself that you can return to old activities, and even accepting the fact that you’re no longer “sick.” Another very real issue cancer survivors face is sexual intimacy. In fact, according to one poll conducted by LIVESTRONG, nearly 60% of cancer survivors report experiencing sexual dysfunction after treatment. Long-term concerns regarding physical intimacy were also reported among as many as 85% to 90% of cancer survivors who were treated for prostate, breast, and gynecologic cancer.

Common Emotional Concerns Regarding Sex after Cancer

Oftentimes, sexual concerns after cancer affect cancer survivors both mentally and physically. Emotionally, both partners may experience nervousness for many reasons, which is completely understandable. After all, one of them just went through a serious illness. A survivor’s partner may worry that they are pressuring or causing physical pain to his or her partner. A survivor may have concerns that his or her partner may no longer find their body attractive if it has been changed by cancer. These “body image issues” involve your mind (how you now feel about your body) and your body (your new physical appearance).  

Physically, there may be concerns from both parties about whether they’ll be able to achieve orgasm due to a lowered sex drive. And, now that the patient/caregiver relationship is no longer needed, it may take time to adjust back into a romantic partner relationship. 

Physical Symptoms of Sexual Dysfunction

The good news is that not all cancers and their treatments are associated with specific symptoms of sexual dysfunction. With that said, some do, so it’s a good idea to have an idea of what to expect. While the following symptoms do not affect all survivors, they are considered fairly common. Fortunately, many of these symptoms will eventually go away.

Breast Cancer

  • Loss of sensation, fatigue, and symptoms related to reconstructive surgery (such as feeling discomfort while getting used to implants) may be experienced by those who had a mastectomy (removal of one or both breasts)
  • Decreased sensation in their breasts and nipples, and lymphedema may be experienced by patients who underwent a lumpectomy
  • Treatments such as chemotherapy, radiation, or hormone therapy could cause patients to experience menopausal symptoms (mood swings, vaginal dryness, vaginal atrophy, and lowered libido or sex drive), fatigue, increased scarring, and lymphedema

Prostate Cancer

  • Surgery for prostate cancer may cause patients to experience erectile dysfunction (inability to achieve or maintain an erection), difficulty climaxing, dry orgasm, and decreased libido 
  • Prostate cancer patients who received hormone treatments may experience erectile dysfunction (ED), lowered libido, hot flashes, and gynecomastia (growth of breast tissue) 

Colorectal Cancer

  • Bowel/bladder changes and complications associated with ostomies/stoma could be experienced by colorectal patients who receive surgery and/or radiation therapy

Gynecologic Cancers: Including Ovarian, Cervical, Vulvar Cancers, or Endometrial (Uterine)

  • Gynecologic cancer patients who receive chemotherapy or radiation may experience fatigue, low libido, menopausal symptoms, increased scarring, bowel, and bladder issues
  • Patients who have a hysterectomy might experience loss of sensation, menopausal symptoms, fatigue, lymphedema in lower extremities, and/or prolapse (when the uterus, bladder, vagina, or surrounding structures begin to fall out of their normal positions)

Talking About It is Important

If you’d like to achieve a healthy and fulfilling sex life after cancer, it’s important that you talk with your partner openly and honestly. The sooner you share your anxieties and fears with your partner the sooner you’ll be on the path toward restoring a sex life that is mutually satisfying. In addition to being healthy, having a discussion is the only way to truly resolve issues. And, a lot of times, couples discover that what they feared most was all in their head.  

Still, it can be difficult at times to talk about intimacy. If you find yourself in a situation like this, you might consider individual and/or couples counseling, which can help you work through your concerns. If you’re experiencing anxiety surrounding your sex life, know that you can also talk with your RMCC oncology team or another healthcare provider. They will most likely be able to recommend therapists, and tools and techniques to improve your libido and sexual function.

Ways To Improve Sexual Desire and Function

As you navigate through this new territory, we encourage you to keep in mind that physical symptoms, emotions, and relationships look different among cancer patients. There is no one-size-fits-all regimen for getting your sex life back on track after cancer. With that said, there are some suggestions to consider:

  • Get enough solid sleep
  • Exercise regularly (get the OK from your oncologist)
  • Find ways to relax 
  • Try to improve your self-acceptance and self-confidence (your partner found you attractive before cancer and may find you even more attractive as a survivor)
  • Ask your doctor if any of your medications may be causing side effects that are inhibiting you sexually 
  • Consider therapy or medication if you have anxiety/depression
  • Experiment with different sexual positions and/or sexual aids
  • Ask your doctor about estrogen as a possible remedy for vaginal symptoms
  • Strengthen pelvic muscles by practicing pelvic floor (Kegel) exercises
  • Use lubricants during intercourse for short-term relief from vaginal dryness
  • Use vaginal moisturizers daily for long-term relief from vaginal dryness

Remember, adjusting to life after cancer takes time. This cancer journey has been a trial for you and your partner, but you’ve endured and made it through! Do all you can to enjoy life and rediscover the things you pumped the brakes on during cancer treatment, including intimacy. Be sure to communicate regularly, remain patient, and show empathy toward each other. And, if needed, consider getting professional help. There are many important components of your overall health and quality of life as a cancer survivor and your sexual health is one of them!