From OncoLog, January 2012, Vol. 57, No. 1
House Call: Sex After Cancer Treatment
Cancer and its treatment can affect a patient’s sexuality, causing side effects that include problems with arousal and inability to achieve orgasm. Yet many survivors don’t realize that help is available for dealing with these difficulties.
The most common sexual problems for cancer survivors are loss of desire and pleasure. Still, according to MD Anderson Cancer Center experts, most men and women can enjoy sex after cancer treatment even if their illness or treatment has created changes to their sex organs or required the removal of some organs in their pelvis.
Side effects in men
Men with cancer in their pelvic area are more likely than men with other cancers to have difficulty resuming sex after treatment. According to a recent report from the Mayo Clinic, sexual side effects for men are most common following treatment for bladder, colon, prostate, and rectal cancers.
Erectile dysfunction—an inability to achieve or maintain an erection—is the most frequent sexual side effect of cancer treatment in men. Other common problems include difficulty climaxing, weaker orgasms or orgasms without discharge of semen, loss of interest in sex, pain during sex, less energy, and feeling less attractive.
Side effects in women
Chemotherapy, radiation therapy, and some medications can lead to symptoms of menopause, such as a thinning vagina, vaginal dryness, or hot flashes. Radiation therapy to the pelvis can damage vaginal tissues, leading to a loss of elasticity and vaginal narrowing and shortening.
For women, sexual side effects are most common after treatment for cancers of the bladder, breast, cervix, colon, ovary, rectum, uterus, and vagina.
The most commonly reported sexual side effects among female cancer survivors, the Mayo Clinic reports, are difficulty reaching climax, less energy for sex, loss of desire, pain during sex, reduced vaginal size, and vaginal dryness.
Finding a solution
If you are a cancer survivor with sexual difficulties, talking to your doctor is an important first step in getting help. Some people find they feel more comfortable when they write down their questions before their appointment.
Your physician may refer you to a specialist in sexual health, or he or she may recommend any of the various treatments available to counter sexual problems after cancer treatment.
For men who have erection problems after cancer treatment, options may include medicines, penile implants, or devices that can facilitate an erection. Often men find that it simply takes time after cancer treatment—as long as 1–2 years—to regain sexual function; however, many physicians advise against a conservative wait-and-see approach and recommend active sexual rehabilitation. Some studies indicate that active rehabilitation—which may include medications or injections that increase the flow of blood to the penis—may preserve function that might otherwise be lost over a year or two.
Women can use a water-based or silicone-based lubricant during sex or use a vaginal moisturizer to counter dryness or tightness in the vagina caused by cancer treatment. If the lubricants and moisturizers don’t help, another option is low-dose vaginal estrogen. For women who have had radiation therapy to the pelvic region, a vaginal dilator can reduce vaginal scarring or shrinking.
Several common emotional changes after cancer treatment can affect sexual function, including depression, anxiety, and changes in self-image. Counseling can help a cancer survivor deal with depression or anxiety that might be causing a loss of desire for sex.
You and your partner may have difficulty coping with cancer-related changes as a couple. Some couples lose intimacy altogether when side effects cause one partner to avoid even nonsexual affection for fear that it will lead to sex. Marital or couple therapy can help you talk more openly about these issues. Let your partner know what you’re feeling and how he or she can help you cope. Together you can find solutions to ease you back into a fulfilling sex life. Explore ways of being intimate, perhaps spending more time cuddling and caressing each other. Do some experimenting and pay attention to what works best.
Many people find talking with other cancer survivors helpful. This could mean joining a support group in your town or connecting with other cancer survivors online to see how they deal with problems similar to yours.
Above all, remember that despite your cancer or cancer treatment, you should be able to feel sexually satisfied. With time and patience and with advice from your doctors, you and your partner will once again be able to enjoy sexual activity.
– K. Stuyck
For more information, talk to your physician, visit www.mdanderson.org, or call askMDAnderson at 877-632-6789.