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Sex After Cancer

Cancer doesn't have to take away your sex life

Depending on the type of cancer they have, 40 to 100 percent of people experience changes in their sexual function after cancer treatment

The reason: Cancer treatments can cause hair loss, weight loss, fatigue, pain, vaginal dryness and impotence, among other symptoms that decrease people's desire and ability to have sex. (People with below-the-belt cancers, such as those of the prostate or the female reproductive system, are most likely to experience sexual dysfunction.)

And it's not always just the survivor who is affected. "Changes to sexual well-being are dynamic and can impact both survivors and partners," says Catalina Lawsin, PhD, a psychologist at Rush. "For example, supportive partners may have higher sexual desire than survivors, but may not want to place any pressure on them. So they initiate sex less often."

Survivors, however, may perceive this change as their partners finding them less attractive. 

This can become a vicious cycle, but it doesn't have to. From open communication to medication to sex toys, there are many ways of improving or reigniting your sex life after cancer:

Talk about your needs

Among these, talking about your needs is one of the most important — whether you're in a long-term relationship or just dipping into the dating pool.

"In many long-standing sexual relationships, people settle into routines," Lawsin says. "So couples might not be in the habit of actually talking about sex." But talking is exactly what you need to do if your body suddenly changes in a way that makes having sex more difficult or less appealing: Only when you've talked honestly with your partner can you start working together to find solutions.

For example, if a woman's vagina becomes tight and dry, penetration may become painful. By saying so, she can direct her partner toward other activities — such as stroking her breasts, clitoris or labia, or stimulating her orally — that may give her more pleasure and less pain.

Similarly, patients may sometimes feel that treatments have left them too weak and tired for sexual activity. In some cases, though, they might find that sex becomes appealing again if they ask their partners to take a more active role so that they can remain more passive.

Changes to sexual well-being are dynamic and can impact both survivors and partners.

Say as much, or as little, as you want

People who are dating or in new relationships face another set of challenges, such as knowing when and how to tell a partner they've had cancer — especially if their treatment caused changes in their fertility or sexual function.

"For some people, having survived cancer becomes an important part of their identity, one they'll discuss with whoever might be interested," Lawsin says. "Others prefer to talk about it only rarely, or only with a potentially long-term partner. The important thing to remember is that there's no one right answer."

If you don't feel comfortable talking with a partner, or if you want additional help, try talking with your doctor or a psychologist.

Work toward the goals that are right for you

At Rush, Lawsin is part of a team of psychologists who specialize in helping people deal with the social and psychological challenges cancer can bring — including sexual problems.

For people unsure how to discuss changing sexual needs — whether they're due to pain, fatigue or  other physical changes — she offers help with communication strategies. For people who want help adjusting to a new body image after a mastectomy, another surgical procedure, or the loss of weight or hair, she offers psychotherapy.

Other specialists can help manage physical symptoms with medications, penile pumps (which help men have and maintain erections) and vaginal dilators (which help stretch vaginal tissue and keep it flexible). Whatever strategy you choose — whether it's taking a medicine or using a device — Lawsin recommends testing it on your own.

"Before you start integrating a partner, try self-stimulating and just generally getting comfortable with whatever you decide to try," she says. "After cancer, if you haven’t had sex or even been stimulated for years, you have to recondition yourself. Even your sex drive is a habit you have to maintain." 

Try new things

Reigniting your sex life can be as much about play as it is about work.

"So try different activities," Lawsin advises. "Try different toys. Rediscover your body. Have fun with it. There's no way to spin cancer in a positive light, and you don't have to. But you can still see it as an opportunity."

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