After cancer treatment many women are left with sexual changes and concerns that, if not attended to, can become long-term problems. Photo: Getty
Over the years I have seen many women who have had cancer; when they were first told their thoughts were all about survival. Sex is probably the last thing on a woman’s mind when she is given treatment options and has to cope with the anxiety of a cancer diagnosis.
However, after cancer treatment many women are left with sexual changes and concerns that, if not attended to, can become long-term problems. Cancer survivors can experience decreased sex drive, changes in sexual functioning and problems with intimacy. Often their partners find it difficult to understand and cope, and report decreased sexual satisfaction and sometimes even sexual dysfunction.
Unfortunately most women are not aware that sexual changes are common after treatment; they may start losing their confidence and find it difficult to be intimate. The impact of their sexual wellbeing is often is not discussed at all and they are therefore ill-informed. It is such a pity, that so many people – and their doctors – still feel awkward and embarrassed talking about sex.
What sexual side effects are most common?
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Loss of desire for sex
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Experiencing pain during penetration
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Vaginal dryness or atrophy
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Difficulty reaching an orgasm
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Reduced size of the vagina
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Premature menopause
Loss of desire for sex
Experiencing pain during penetration
Vaginal dryness or atrophy
Difficulty reaching an orgasm
Reduced size of the vagina
Premature menopause
The good news is there are treatments and strategies that can manage the sexual changes they experience and enhance their sexual wellbeing.
Loss of desire can be caused by worry, depression, fatigue, nausea and pain. Cancer can affect the normal hormone balance which also can lessen desire. Women can experience negative thoughts and worry that their partners will be turned off by changes in their bodies or just the word “cancer” is scary. Fear of pain can also lead to loss of desire.
We shouldn’t overlook the emotional effects a cancer diagnosis can bring up for some women: the feelings of being sad or depressed, concerns about changes in the way they look, stress in the relationship with their partner, and difficulties with their self-esteem. All those emotional feelings can interfere with feeling attractive and wanting sex at all.
Pain during penetration is a common problem, often related to changes in the vagina’s tissues or size. These changes can happen after pelvic surgery, radiation therapy or treatments that affected the female hormones.
Sometimes the pain sets off a condition called vaginismus. The muscles around the opening of the vagina become tense, without the woman being aware of it. This makes penetration very difficult. Pushing harder increases the woman’s pain because her vaginal muscles are clenched in a spasm. Counselling and retraining of the pelvic-floor muscles by specialist physio-therapists are recommended.
Vaginal dryness and atrophy causing intercourse to be painful is another common problem after treatment. This is most often caused by a lack of oestrogen to the vaginal tissue. Some ways to help alleviate the discomfort include over-the-counter vaginal lubricants or using intravaginal low-dose oestrogen (Vagifem), which acts locally on the vaginal tissue. Very little is absorbed into the blood stream.
Few cancer treatments (except those affecting some areas of the brain or spinal cord) damage the nerves and muscles involved in reaching an orgasm. Women whose vaginas are tight or dry can reach orgasm through stroking the outer genitals. Partners can help each other reach orgasm, but sometimes just cuddling can also be very satisfying and pleasurable. To stay feeling sexual it’s a good idea for a woman to continue pleasuring herself.
The symptoms of premature menopause are faster and more intense that the slow changes that happen during normal menopause. Some women can take hormone replacement but it’s important to discuss this with a specialist doctor.
The University of Sydney and the Cancer Council of NSW have identified that many cancer survivors are suffering in silence and need support. They have developed a world-first personalised online resource, called Rekindle, to improve the sexual wellbeing of all cancer survivors and their partners.
Clinical health psychologist Dr Catalina Lawsin, who leads the team said: “We created this resource so people don’t feel alone and overwhelmed, but can access practical advice and learn skills in a confidential environment to improve their sexual wellbeing.”
Cancer survivors, whether in a relationship or single, and partners, are invited to use this resource. Rekindle will be personally tailored to meet your specific needs. It can be used on any device, including laptops, tablets and smart phones. It is available 24 hours a day, seven days a week.
You still can have an active sex life after cancer, so please check it out!