You, your partner and sexuality
Sexuality is very personal and means different things to different people. Cancer and its treatment can have a big impact on your sexuality.
How cancer affects you and your sexuality will depend on the type of cancer you have, as well as the treatment and its effects.
It’s common for people with a cancer diagnosis to say their sexuality has been affected, but having cancer doesn’t have to mean an end to your sexuality. With support and clear communication, many people living with cancer still have sexual feelings and can enjoy a fulfilling sex life.
When someone becomes ill, it can affect their ability to feel good about themselves sexually. It may also affect their physical ability to give and receive sexual pleasure. Some changes may only be temporary, but even if the changes are long term or permanent, you can adapt your sexual techniques or even discover new ones.
You may need to focus more on sensuality than sexuality at this time. Using touch can be an important way of telling someone how you feel, and it can help you communicate emotions that aren’t easily expressed in words.
Remember that you are a unique person and that you’re allowed to focus on your own needs and desires. You can change your mind about what you enjoy, find new things pleasurable and communicate in new ways.
How cancer can affect sexuality
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Cancer or its treatment can affect your:
physical ability or energy to give and receive sexual pleasure
thoughts and feelings about your body (body image)
role within your relationship.
Tiredness is a common problem and can be due to the cancer, its treatment or emotional strain. If you’re feeling tired, you may lose interest in sex during or after cancer treatment.
Pain can reduce sexual feelings and sexual desire, which are different anyway from person to person. If one partner has previously been more interested in sex than the other, then cancer can exaggerate this.
Your body image
Body image is the picture you have in your mind of how you look (your size, shape and form) and how you feel about your body. A change in body image may make you feel anxiety, shame or embarrassment. The reactions of a partner can influence these feelings.
Some treatments for cancer can affect our body image. For example, women who have been diagnosed with breast cancer may have all or part of their breast removed (a mastectomy) as part of treatment. Testicular cancer may be treated by removing the affected testicle. Having one of these body parts removed can significantly change how you and your partner feel about your body and may affect your sexuality. But even if the part of your body that is affected by cancer is not visible from the outside, it can still make you feel different about yourself and your body.
You might find our section about coping with body changes after cancer helpful.
Emotions can have a powerful influence on our sexuality and our sexual behaviour. Being told you have cancer often causes many strong emotions that may make you or your partner less, or sometimes more, interested in sex.
Normal, everyday feelings can be intensified. This can be exhausting and may lead to a loss of interest in sex, although some people can feel an increase in sexual arousal. You may also become preoccupied with other worries such as financial concerns.
You may feel that you have enough to worry about without thinking about sex.
If you are experiencing any of these problems, you may find your cancer doctor or nurse can help. They may be able to suggest a small change that could make a big difference to how you feel.
Hormonal replacement therapy (HRT), for example, can be used safely in some women to increase general well-being and sexual desire.
Your partner's concerns
Partnersof a person with cancer may be afraid to touch them intimately for fear of causing pain or damage to the area of the body being treated. They may lose desire themselves as a result of changes in the person with the cancer or feel rejected because their partner is less interested in sex.
Although cancer can’t be passed on like an infection, a partner may even be afraid that they may ‘catch’ cancer through sexual contact.
A cancer diagnosis can lead to a change in role for either of you. You may not be able to do all the things you used to do before the diagnosis, and this may affect your sexual self-esteem.
Effect of treatment on sexuality
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The main treatments for cancer are surgery, radiotherapy, chemotherapy and hormonal therapy. They can all have physical effects on sexuality.
Having an operation of any type can affect your ability to have sex and your level of sexual desire. Surgery in the pelvic area - for example, removal of the womb (hysterectomy) in women, and removal of the prostate gland to treat prostate cancer in men - can affect the nerves in that area. This can change how an orgasm feels for women, or can affect a man’s ability to get and maintain an erection (erectile dysfunction).
to the pelvis can cause soreness and tiredness. Pelvic radiotherapy in women may cause a narrowing of the vagina or lead to early menopause. Pelvic radiotherapy in men may cause erectile dysfunction.
can have a temporary effect on a person’s sexuality. Both men and women may find their sex drive is lower for a while. It can also bring on the menopause in women and this may cause vaginal dryness. It’s thought that chemotherapy drugs don’t pass into semen or vaginal fluids. However, just in case, most hospitals advise that you use condoms for a few days after you or your partner has had chemotherapy.
may be given to some women with breast cancer and to men with prostate cancer. They can cause menopausal symptoms in some women. In men, hormonal therapy reduces the level of testosterone being produced in the body. This may mean that they have a lowered sex drive and difficulty getting and keeping an erection.
There are a number of different things that can help couples have a fulfilling sex life:
Make time for yourself and your partner.
If you’re very tired it may help to make love differently. For example, you can use a less energetic position or have quicker sexual contact rather than longer sessions.
Let your partner know if you don’t feel interested in sex.
If you have pain or discomfort, plan to make love after taking pain medicines. Use pillows and cushions to help you get more comfortable. It may help if you take control over the depth and speed of penetration.
If you prefer not to have penetrative sex, then you may find it satisfying to give and receive sexual pleasure in other ways.
Medicines and other devices can help with problems such as vaginal dryness and impotence. You can discuss this with your doctors or nurses at the hospital.
If you’re feeling self-conscious about how you look, talking with your partner about how you feel can help you regain some confidence. Focus on a part of your body that you like and use this as a foundation to build confidence in your body. Practical ways to help may include making love while partly dressed, keeping the lighting low or using candlelight.
There are a number of organisations that can help couples who are having problems with their sex life. Although it can be embarrassing to talk about at first, most people find it helpful to get some advice and support.
There are no right or wrong approaches – just focus on what works for you as a couple.
How you touch and hold each other will show your feelings for each other; holding each other closely or using massage are both ways of physically showing your love. It’s important to remember that having sex doesn’t cause cancer to spread and it won’t make the cancer worse.
Many people are devastated when they discover that the surgery, radiotherapy or chemotherapy treatment they need mean they can no longer have children. This is not the case for all treatments. You may want to discuss the risks of infertility and all your options with your nurse or doctor and your partner before you start treatment.
If the treatment you have for cancer may cause you to become infertile, you and your partner may both need to speak to a professional counsellor or therapist specialising in fertility problems.
You might find our section about cancer and fertility helpful.
Watch our video about some of the common sexual problems, and what can help.
Amanda talks about how breast cancer affected her relationships.