Many people express concern about sexual issues while they are undergoing cancer treatment. In one study, 82% of people undergoing active cancer treatment wanted to discuss sexual issues with their primary care physicians, but others said that sex was the last thing on their minds when they were being treated for cancer.
"If you have a good body concept before treatment and a good sexual relationship, this is the best predictor of a good outcome," says researcher Deborah Watkins Bruner, RN, PhD, who educates women with cancer on sexuality issues.
In a focus group of 25 women recovering from breast and gynecological cancer treatment, one woman said that she would have discarded any survey or discussion about sexual issues if she had received it too soon after her diagnosis. She, and most of the married women in the group, said that six months to a year after treatment would have been the right time to discuss sexual issues. The single women felt differently—they would have wanted to discuss sexual issues immediately.
No matter where you are on the spectrum of breast cancer treatment, you may want information on sexual issues that you're facing now, or that you're concerned about for the future. And remember, compared to surviving the trauma of cancer, sexual issues are probably much easier to overcome.
One side effect of chemotherapy is vaginal dryness, the result of early menopause caused by damage to the ovaries during treatment. This can be overcome with the help of a good lubricant. Although some lubricants are too thick and greasy, there are others that nearly mimic nature. You might want to consider Silk-e, Astroglide, or ID Millennium. Some oncologists would prefer you not to use an estrogen-based lubricant, since your body may absorb some of the estrogen. The issue of using estrogens after treatment for breast cancer is controversial. You should discuss possibilities with your doctor.
Losing a breast through a mastectomy can considerably impact your sex life. But some research and clinicians maintain that for many women, having a mastectomy does not interfere with sexual enjoyment.
Even if you feel entirely comfortable with your sex appeal, the thought of sexual intercourse may not appeal to you. You may not feel the desire, or you may be experiencing the fatigue that can last long after chemotherapy is over. For whatever reason, the idea of sexual activity may seem daunting.
You can resume intimacy—without the pressure of performance—with sensate focus exercises. Although she didn't originate the concept, Schover describes these exercises in-depth in her book.
The exercises are aimed at increasing in-the-moment sensation and decreasing any pressure you may feel to achieve orgasm or perform intercourse. They can be broken down into three steps:
The sensations you share might include soft kissing, light touching or massage—any type of touch that you or your partner enjoys.
Regardless of all the self-help information about reviving your sex life after breast cancer treatment, don't forget the most important point: If you don't feel like having sex, for whatever length of time, you don't have to.
"Sex is not love," says psychologist David Bullard, PhD. "You can certainly have a loving, deep intimate relationship without a sexually intimate part to it. But if you miss it, if it's been interrupted by cancer treatment, and it's been important [to you] in the past to be sexual, there is help available for couples who want to resume the shared experience of sexual intimacy."
Canadian RESOURCES:
Canadian Cancer Society
http://www.cancer.ca/
Women's Health Matters
http://www.womenshealthmatters.ca/
Last reviewed June 2009 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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