How to keep intimacy, romance and sexual relationship with your partner alive when you're going through cancer treatment...
Talking openly about cancer isn’t always easy, and the same can be said about sex. Combine the two and the silence becomes deafening. Yet being open about the changes cancer brings to anyone’s sex life is the first step towards improving matters.
Yes, there are emotional and physical hurdles, but there is now lots more support to help you keep intimacy, romance and sexual relationship with your partner alive when you're going through cancer treatment.
Why cancer can change your sexuality
Cancer treatment affects sexual relationships for both men and women for several reasons.
Chemotherapy can lower levels level of oestrogen and testosterone.
In women, the lack of oestrogen causes thinning of the vaginal lining, making sex uncomfortable.
Lower testosterone affects a man’s ability to get or maintain an erection and how he orgasms, and can reduce sex drive in both partnerts. So one or other of you is not in the mood, and even if you were, it might be physically impossible. Cancer may no longer be such a killer disease, but it can still be a passion killer.
Physical changes like breast surgery, or the need for a pouch after bowel or bladder surgery and the scars that these can leave, along with hair or weight loss can deal a huge blow to how sexually attractive you feel and lead to anxiety and insecurity around physical intimacy.
The effect of cancer on sex tends to vary in different age groups.
Young people may worry about being different from their peer group, or how to find a new partner. Judging if and when a new sexual partner will be understanding and supportive about sexual intimacy issues may take more thought than usual.
Couples in mid-life may experience frustration and tension and fear relationship breakdown. Bottling these feelings up will not help, so it’s important to understand their causes and talk about how to deal with them. If this is difficult, it's worth considering speaking to a professional therapist.
Older couples whose sex hormones will in any case decline naturally, may find a less active sex life easier to come to terms with.
“Our feelings for each other have not changed and we still enjoy hugs and cuddles, go out for meals and have great holidays and long walks.” Community forum member with prostate cancer
Some couples even find that a cancer diagnosis brings them closer together, reigniting the spark that first drew them together.
You can watch a video in which a sex therapist who works for Macmillan Cancer Support talks about these issues here, and the charity and has lots of information abour sex and cancer on its website and a free helpline on 0808 808 00 00.
So, what about the practicalities?
Making sex easier
Moisturisers and lubricants
Women who experience discomfort or pain during sex because their vagina may have shrunk or has a thinner lining, can experiment with different types of soothing moisturisers and lubricants.
Your GP can also prescribe oestrogen cream which is applied internally and gradually restores the vaginal lining.
Vaginal dilators do what they say: help to ease penetration by gradually expanding your vagina. This can help especially if you haven’t had sex for while and dread the idea of penetration.
Non-penetrative vibrators such as Magic Wand can help with arousal, while a penetrative model may work for couples where the man has become impotent or has problems getting or maintaining an erection.
Getting an erection
If getting an erection is a problem there are several approaches. Medicines that increase blood flow to the penis like Viagra can help, but you should seek medical advice if you are taking other medication or undergoing treatment for cancer. Pumps can help you get an erection and a constriction ring can help maintain it.
Try different positions
Surgery can make certain positions off limits, so explain this to your partner, and if you feel self conscious about scars or loss of a breast, try kneeling standing or spooning positions.
Boost your confidence
It’s totally normal for your body image and confidence to take a knock as a result of cancer treatment, but if some sexy underwear would help there are a range of mastectomy bras and you can read a guide to ostomy underwear here. Ostomy pouches can also cause embarrassing leaks and smells - nothing romantic about those - but there are ostomy products to help with that too.
Give yourself time
If you haven’t been able to or wanted to have sex for sometime, rekindling romance and intimacy may feel awkward. Discuss starting gently with cuddles, kisses and stroking and see where that eventually takes you - what therapists call ‘sensate focus’. It may not be very far, but showing your partner that you find them attractive doesn’t always have to mean going the whole way.
- The Eve Appeal is a charity specialising in women’s cancers - womb, ovarian, cervical, vaginal and vulval. It offers support for sexual problems and you can speak to a specialist gynaecological cancer nurse via its freephone number 0808 802 0019 or email firstname.lastname@example.org
- To find out more about male cancers (prostate, testicular and penile) visit the charity Orchid.
- The College of Sexual and Relationship Therapists has a searchable database by postcode. Some therapists have expertise in dealing with cancer related problems.
- Anne Katz is an award-winning Candian sex counsellor and nurse who writes and blogs about cancer and sex for men and women.
And find more tips and share your own in the Live Better With Cancer community forum.
Browse the Live Better With Cancer collection of recommended products to help with having sex here.