In order to understand any physical changes which occur due to your cancer or its treatment, it may be helpful to be reminded of the sexually sensitive areas of your body and how they respond to stimulation.
A woman’s sex organs are mostly inside her body. This includes the uterus (womb), the cervix (neck of the womb), the fallopian tubes and the ovaries.
Other sexual areas of the female body include the breasts and nipples, which change in hardness and sensitivity when touched. Women also have other sensitive areas on their bodies that respond to direct touch, such as the nape of the neck, the backs of the knees, the buttocks and the inner thighs. The sensitivity of these areas, known as erogenous zones, varies from woman to woman.
In a man, the sexual organs are mostly outside the body. This includes the penis and the testicles (testes or balls). The end of the penis is covered by the foreskin, unless the man has had it removed by circumcision. The ridge on the underside of the head, called the frenulum, is usually the most sensitive part of a man’s penis. At the very top of the penis is a slit that opens to the urethra, which semen and urine pass through to leave the body.
At the base of the penis is a bag formed by wrinkly skin called the scrotum. Inside the scrotum are the testicles. These produce sperm, which are then passed through tubes (known as vas deferens), to mix with other fluids to make semen.
The rest of a man’s sex organs are inside his body. The prostate gland sits deep in the pelvis and surrounds the first part of urinary tube (urethra), as it leaves the bladder. The prostate gland produces a fluid that mixes with the sperm to form semen. It also helps create the intense sensations a man feels during an orgasm.
The penis, testicles and anus are erogenous zones. A man’s chest and nipples can also be sensitive, and his body may have other erogenous zones. The sensitivity of these areas will vary from man to man.
Stages of sexual arousal
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Sexual desire, also known as libido, is the name for interest in sex. Everyone’s desire for sex is different. It can vary between men and women, and according to things such as age, events that happen in your life, your state of mind and changes in your body. For example, many people find their desire for sex reduces with increasing age or if they are stressed, tired or unhappy. Most women also find their desire changes throughout the menstrual cycle, when they are pregnant or breast-feeding, and after the menopause. Feelings and relationships can also greatly influence the desire for sex in many people.
Excitement or arousal
This is the awakening of sexual feelings, when we feel ‘turned on’ and ready for sex. These feelings can be produced by simply seeing someone we’re attracted to, touching or being touched by a lover, thinking about sex, or having our sexual areas touched. Arousal may or may not lead to orgasm.
This is the phase where the body maintains a heightened state of arousal. The body is very sensitive during this phase.
This is the sexual climax - the feelings of intense pleasure that occur as areas of the body go into a series of rhythmic contractions. Some women can feel their uterus contract during orgasm. Men ejaculate semen, unless they have had surgery (vasectomy) that affects the production of sperm.
This is the phase that follows sexual arousal and orgasm. This is when the sexual changes in the body go back to normal. Men can’t usually be sexually excited again for a while. However, many women can be aroused to orgasm again straight away. As people get older they tend to lose the ability to become sexually excited repeatedly.
Emotional effects on desire and sex drive
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Desire and sex drive make us act in a certain way when we’re sexually aroused. Desire isn’t fixed - it changes over the years. Many things can reduce sexual desire, including:
mood changes (such as anxiety)
changes in contraception methods
feeling unhappy about your body
traumatic sexual experiences in the past
excessive drug or alcohol use
boredom with your sexual routine.
Desire for sex is greatly affected by your state of mind. If you’re depressed, anxious or afraid about your cancer, its treatment or your relationship, you may find it more difficult to be sexually aroused.
Physical effects on sexual response
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For the phases of sexual arousal to occur, certain systems in the body need to be working normally.
Physical arousal, plateau and orgasm will only happen if the body has a good blood supply, if the nerves to the pelvic area are working well and if the balance of hormones in the body is right.