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Intimacy
and Sex After Cancer Treatment
Serious illness impacts all areas of a person’s life and
can put overwhelming stress on dating and relationships. Illness and
treatment can impair intimacy and sex.
For example, recent studies have found that at least 60%
of people who have been treated for cancer experience problems with sex
(some studies have found much higher rates). Often, medical
professionals do not invite or encourage discussion of relationship or
sexual
difficulties. When patients experience problems they may be too
embarrassed to ask for help or may believe that nothing can be done to
restore intimacy and sex. The result is that only about 20% of people
who have been treated for cancer report that they received the help
they needed with sex and intimacy problems.
Cancer treatments bring physical changes to a patient's
body, which may change the appearance and/or function of some areas of
their body, including their sexual organs. Loss of desire is common and
can be a direct result of treatment. In cases where
surgery,chemotherapy, or
radiation has damaged sensitive tissue or organs, or where surgery has
removed tissue or organs, regaining sexual function may seem hopeless.
Emotional reactions to these changes can include grief,
anger, shame, embarrassment, depression, performance anxiety, and low
self-esteem. People often struggle with negative body image and feel
unattractive, undesirable, and unlovable. These feelings can increase
the patient's vulnerability and fears about intimacy and sex. As a
result, they may pull back from their partners, or if single, may avoid
dating.
These reactions can contribute to decreased desire, increased pain, and
erectile dysfunction (ED).
There may be times when people feel too tired, broken,
or vulnerable to ask for the love and intimacy they need.
They may begin to believe that distance is less stressful than
closeness. And after experiencing frustrating, uncomfortable, or
painful attempts to have sexual intercourse, many people give up
trying to find any kind of sexual pleasure.
Illness can turn your world upside down and threaten
everything you hold dear. At times, the path to healing will present
huge frustrations, difficult changes, and painful losses. However,
there is hope because our bodies and brains have a surprising ability
to adapt to changes and to heal in ways we cannot imagine. We are
resilient.
There is an old saying that the most important sex organ
is the brain. This is so true in the recovery of intimacy and sex
because satisfying intimacy and physical pleasure are not limited by
the performance of our sex organs. For most of us (whether we have had
cancer or not), it will take re-education to let go of beliefs and
habits that block our ability to experience satisfying intimacy and to
learn new paths to pleasure. It will take new communication skills to
navigate the challenges of healing and recovery.
Cancer and cancer treatments impact all of the systems
that make up a person: physiological, biochemical, social, emotional,
and spiritual. Recovery requires a combination of resources that can
heal all parts of the person. Different resources may be needed at
different stages of recovery.
Tips
for Patients and their Partners
- Schedule frequent quality time with your partner. You
need time to be together with no
expectations, judgments, or distractions. Quality time fosters
intimacy, which is an important resource for healing. Intimacy can
include feelings of affection, closeness, comfort, belonging,
understanding, connection, togetherness, and nurturing. It may or may
not include spiritual, romantic, and/or sexual feelings. It may or may
not include spoken words, comforting touch (like holding hands),
sensual touch, erotic touch, and/or sexual activities. Be honest,
specific, and clear about your what you want and don’t want. Give
yourself permission to revise at any time. It’s always okay to say “no.”
- Update your communication skills. Average skills will
not get you through the tough times. It will take courage and trust to
reach out when you are feeling vulnerable. Speak up, ask for what you
want, and take more risks to share your feelings honestly, no matter
how difficult. You have a right to your feelings—to feel whatever you
are feeling, regardless of what anyone else thinks or says.
- Learn meditation and mindfulness skills. Learn how to
quiet your mind and soothe yourself and how to live in the present
moment. Get quiet and just breathe. Satisfying intimacy grows out of
being fully present.
- Let go of expectations and agendas. The biggest
barrier to pleasure is our thinking—not our body or our sexual organs.
Spend time alone getting to know your body as it is now. Be open and
curious about new ways to feel pleasure alone and with your partner.
For now, take sexual intercourse (penetrative sex) and orgasms off your
agenda. Focus on intimacy—give yourself permission to be present in the
moment, to connect emotionally and spiritually, and to explore whatever
touch feels good. Everything is an experiment. Go slow. Breathe.
- Give yourself permission to grieve your losses.
Grieving is different for each individual. It takes time and goes at
its own pace—it cannot be rushed. Some grieving is solitary, but some
needs to be shared with loved ones.
- Be gentle with yourself and your partner. Give
yourself and your partner a break whenever needed, but don't give up.
Be kind to yourself.
- Continue to ask questions and seek help. Don’t let
embarrassment stop you. Get all of the help and support you need. Talk
with Dr. John and other professionals who understand these issues—they
can
help you bring
satisfying intimacy and sex back into your life. Find out more about how Dr. John can help you.
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