Cancer and Intimacy: Physical and Emotional Issues


When you have cancer, the closeness and comfort of a partner may be more important than ever. But illness may take up much of your time and energy, leaving little left for intimacy. The emotional effects of cancer and its treatments are often enough to douse your desire for sex. Some cancer treatments may cause side effects that directly affect your physical ability to take part in and enjoy sexual intimacy.

Different issues for men and women
Side effects of cancer and its treatment may reduce sex drive (libido) and cause both men and women to feel less attractive. Different types of cancer may cause unique issues for men and women.

In men, treatments for prostate or colon cancer can cause erectile dysfunction (also called ED or impotence).

In women, treatment of pelvic cancers can lead to severe vaginal dryness and pain with intercourse. It can also cause loss of sensation and trouble having an orgasm. Breast cancer and mastectomy may make a woman feel less attractive.

How cancer treatment may affect your sexuality
Many factors, including the type of cancer and treatment, can impact sexual function.

Surgery after-effects can affect your sexual function. Surgery to the pelvic organs or breasts may literally hit close to home in terms of sexual function. The effects surgery may have on your sexual function will depend on factors such as your age and overall health.

Chemotherapy can cause a variety of side effects such as nausea, fatigue, hair loss, and weight gain. These can sap energy, reduce sexual desire, and lower self-esteem. In women, chemo can lead to vaginal dryness, pain during intercourse, and problems having an orgasm. After chemo, men sometimes have trouble making testosterone. This can interfere with sexual functioning.

Radiation side effects are similar to those of chemo. They can reduce the desire for sex. Women who have radiation treatment in the pelvic area may have changes in their vaginal lining, making intercourse painful. Men may have sexual problems, including ED, after radiation. The risk of these problems is greater in those who smoke or have heart disease, high blood pressure, or diabetes.

Hormone therapy to treat prostate cancer may lower a man’s hormone levels. This affects his desire for sex as well as his ability to have an erection or orgasm.

Other factors

•Psychological factors such as anxiety and depression that may go along with cancer can affect self-image and desire for sex.
•Chronic pain is often part of having cancer. Both the pain itself and the medications for it can affect sexual desire and performance.
•Myths about cancer and sex may lead some people to avoid intimacy. It’s important to know that these are myths and not true. For instance, having sex will not make cancer worse. Cancer treatments, such as radiation or chemotherapy, have no effect on anyone other than the person who has the treatments.
Suggestions for overcoming barriers and restoring intimacy

•Communicate. Talk with your partner and your doctor. Let your doctor know about any sexual problems you are having. Medical devices and medications may help. Tell your doctor if you feel depressed or anxious, so you can get help. Share your feelings and let your partner know that you still want to be close but may need to make some changes in your physical relationship.
•Maintain physical closeness. There are other ways than intercourse to stay physically connected, such as cuddling, kissing, and touching. If you have problems, make adjustments and explore new ways to achieve sexual pleasure. Physical contact can help you cope with the stress of not feeling well.
•Enhance your self-image. You may feel less attractive because of hair loss, weight gain or loss, or some other effect of your treatment. Remember that there’s a lot more to you than the physical. Your inner qualities can still shine through. When you are ready, you may also want to take action to improve your self-image. Explore medical options, such as breast reconstruction or medications or devices to improve erectile function, that may help you feel better about how you look.

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