You, your partner and sexuality
Sexuality is very personal and means different things to different people. Whether you are heterosexual (straight), lesbian, gay, bisexual or transgender, 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. But having cancer doesn’t have to mean an end to your sexuality. With support and clear communication, many people living with cancer still 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 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.
Effect of cancer on sexuality
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Cancer or its treatment can affect your:
physical ability to give and receive sexual pleasure
thoughts and feelings about your body (body image)
emotions, such as fear, sadness, anger and joy
roles and relationships.
Tiredness is a common problem and can be due to either the cancer or its treatment. 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 varies from person to person. Often one partner may be more interested in sex than the other, and cancer can exaggerate this.
Body image is the mental picture we have of our own appearance. This image may not come from how we actually look, but rather from how we think we look. A change in body image may make you feel emotions such as anxiety, shame and 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. Having a mastectomy can significantly impact how you and your partner feel about your body and may affect your sexuality. 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 interested in sex.
You may become preoccupied with other worries such as financial concerns. Normal, everyday feelings can be intensified. This can be exhausting and may lead to a loss of interest in sex, although some people feel an increase in sexual arousal. You may feel that you have enough to worry about without concerning yourself about sex.
Partners of a person with cancer may be afraid to touch them intimately for fear of causing pain. 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, they may even be afraid that they may ‘catch’ cancer through sexual contact.
A change in role can occur for either of you can occur as a result of a cancer diagnosis. You may not be able to do all the things you used to do before the diagnosis. For some people, fulfilling their role as a mum, dad or breadwinner is part of their 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.
Surgery 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 alter the sensation of orgasm for women or affect a man’s ability to get and maintain an erection (erectile dysfunction).
Radiotherapy to the pelvis can cause soreness in that area. It can also cause tiredness. Pelvic radiotherapy in women may cause a narrowing of the vagina and may also lead to an early menopause. Pelvic radiotherapy in men may also cause erectile dysfunction.
Chemotherapy can have a temporary effect on a person’s sexuality. Tiredness can cause a lack of interest in sex. It can bring on the menopause in women, and this may cause vaginal dryness. Both men and women may experience a temporary lowering of their sex drive. 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.
Hormonal treatments 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, which may mean that the man has a lowered sex drive and also has difficulty getting and keeping an erection.
There are a number of different things that can help couples have a fulfilling sex life:
Relax and 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.
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 or keeping the lighting low.
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 support.
There are no right or wrong approaches - just focus on what works for you as a couple. You may feel that not having penetrative sex is fine, and you may be satisfied with giving and receiving sexual pleasure in other ways.
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.