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Cancer can put a strain on intimate relationships. Treatments for cancer and the disease itself can cause changes in sexual desire and function. If your physical appearance has changed, you may feel less attractive or desirable. At the same time, your partner may feel helpless, fearful, or unsure how to support you. All of these issues can form barriers to intimacy.
The causes of sexual dysfunction are often both physical and psychological. Cancer and its treatments, particularly those involving the genital or reproductive organs, can directly affect sexual functioning and desire. The side effects of cancer treatments (e.g., fatigue, nausea, vomiting, constipation, pain) can also decrease sexual feelings.
In addition, you may be dealing with anxiety and depression, which may impede sexual desire and functioning. These feelings can become amplified if your physical appearance changes, due to surgical scars, hair loss, weight gain/loss, etc. These physical changes can make you feel unsexy or insecure.
There are notable differences in the issues men and women face regarding sexuality and intimacy during cancer treatment.
For some women, cancer and its treatments may cause a range of symptoms that interfere with sexual function and physical intimacy, such as the following:
A common symptom for some women with cancer is vaginal dryness, which can make sex painful. Often, vaginal dryness and discomfort is caused by declining estrogen levels. Some cancer treatments may also trigger the onset of menopause, resulting in hot flashes, mood swings, decreased libido, and vaginal dryness or tightness.
In addition, some types of pelvic surgery (e.g., removal of the uterus, ovaries, or bladder) can decrease vaginal lubrication and sensation, contribute to loss of vaginal elasticity, and cause pain. Breast cancer surgery may cause reduced physical sensation, so the breasts may not be the source of pleasure they once were. Radiation therapy to the pelvic area can cause changes in the vaginal lining, making intercourse painful.
A woman should discuss her concerns with her doctor, who may recommend medical treatments (e.g., estrogen replacement therapy), vaginal dilators, vaginal lubricants, or estrogen creams to make intercourse more comfortable.
Counseling may also be recommended, as body image issues can cause psychological and emotional distress. In addition, if a women desires to have children in the future, she should discuss her options as some cancer treatments may cause infertility.
For some men, cancer and its treatments may cause a range of symptoms that interfere with sexual function and physical intimacy, such as the following:
Some treatments for men with cancer can interfere with the ability to have an erection, ejaculate or reach orgasm. For example, some surgeries, such as for prostate, bladder and colorectal cancers, can damage nerves and blood vessels and result in erectile dysfunction (ED), and problems with ejaculation and orgasm.
Radiation therapy to the pelvis can damage the arteries that bring blood to the penis and cause problems with getting and keeping an erection, as well as incontinence. Chemotherapy may interfere with testosterone production in the testicle, which can impact sexual functioning. Hormone therapy for prostate cancer may decrease a man’s hormone levels, reducing the ability to achieve an erection or orgasm.
A man should discuss his concerns with his doctor, who may recommend nerve-sparing methods during surgery to preserve erectile function. Other treatment methods may include: medications, injections, vacuum devices, implants, or testosterone replacement.
Counseling may also be recommended, as physical changes can make a man question his masculinity, causing emotional distress. In addition, if a man desires to have children in the future, he should discuss his options as some cancer treatments may cause sterility.
Intimacy has different meanings and importance for each of us, and can be expressed in various ways. When cancer enters your life, roles and relationships change. For many, an intimate connection with a partner is an important part of feeling alive and whole during cancer treatment. And, while it may take persistence and teamwork to maintain intimacy in your relationship, it can be done.
NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING SEXUALITY AND INTIMACY DURING CANCER CARE.
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