Let's talk about something that many cancer survivors will experience, but so few openly discuss. I know many find themselves embarrassed to discuss the topic of sex and intimacy after cancer, myself included. But the impact of cancer on sexual function and intimacy has been sidelined for too long and needs addressing.
Although cancer professionals seem comfortable discussing sex pertaining to fertility preservation, the impact of cancer treatment on sexual pleasure and intimate relationships is rarely discussed in cancer care. The topic of sex and intimacy after cancer is not normalized and we need to start addressing this in an honest, open, and meaningful manner, as it is something that many who undergo cancer treatment will want help and support with.
It might seem frivolous to complain about issues around intimacy and sex if you have survived cancer, which is why many people suffer in silence. When it feels like no one is discussing these concerns, it only makes experiencing these problems even more isolating as you are left questioning ‘Am I the only one?’.
A Livestrong survey of 2,307 people (85% of which were aged 20-54 at diagnosis) concluded that:
- 46% of cancer survivors experienced issues with sexual functioning after treatment.
- 71% received no care or advice when they experienced sexual dissatisfaction or dysfunction after treatment.
- 62% experienced emotional concerns around altered personal appearance.
- Prostate cancer, breast cancer, and gynecologic cancer survivors report the highest amount of long-term concerns regarding physical intimacy.
Everyone who has experienced cancer will go through the personal journey of learning to trust and feel comfortable within our bodies again. But it can be difficult to establish how cancer might have impacted our intimate and sexual relationships.
Whether major surgery has impacted sexual enjoyment or performance, you are suffering from the side effects of surgical menopause, or you are experiencing other physical or emotional traumas of cancer treatment, life after cancer can leave you feeling like a stranger in your own body.
Reconnecting with your intimate needs after cancer.
Intimacy issues are so closely tied up with body image and the perception of how we look. After cancer, it is important to address the changes to our body, what we can / cannot do now, and what we feel comfortable with. We may not feel comfortable being intimate with others if we have not yet attempted to reconnect and reestablish intimacy with ourselves.
‘Body image is defined as the mental picture of one’s body, an attitude about the physical self, appearance, and state of health, wholeness, normal function, and sexuality.’ (Source)
If you have avoided sexual activity for a while, you may find that you are less inclined to see intimacy and pleasure as a need or priority. We need to allow sex, pleasure, and intimacy to become holistic parts of the healing process after cancer, just as we do by adding yoga or mindfulness for our mental and physical recovery.
Putting the ‘self’ back into self-care.
Time for the awkward but essential truth. Intimacy with yourself is the easiest relationship to re-establish first. This is especially true if you've been intimate with a partner after cancer and found this to be a distressing or upsetting experience. This negative experience only exacerbates our reluctance to participate in future sexual activity and can make lines of communication in relationships break down.
If cancer treatment has impacted the intimate activities that you used to enjoy and you're unsure what you feel comfortable with, taking control and working on your self-pleasure and stimulation is a good place to start. You can take this at your own pace and be fully in control of the situation.
- Your partner might feel too scared to initiate intimacy because they are worried about hurting you. Going solo allows you to find out what you feel comfortable with and what may cause you discomfort or pain.
- Go back to the basics and take the time to discover how different sensations feel by finding new, pleasurable parts of your body.
- Taking time for self-stimulation allows us to reconnect with our desires and find what makes us feel good again.
- The goal is not to please others, simply to find out what you enjoy when the pressure of ‘performing’ is taken away.
- The brain is our biggest sexual organ. If negative thoughts are preventing sexual enjoyment, focus on tuning in to how you are feeling when you take time for self-pleasure. Being mindful of how sensations feel allows you to shift the focus away from thoughts that might be creating a block in your mind.
- Feel confident in speaking to your medical team about the help they can provide if you are experiencing sexual difficulties. For physical concerns, there are lubrications, dilators, and hormonal options (to name a few.) These are all recognized medical aids but may need to be prescribed with the guidance of a medical professional.
- If you are finding intimacy after cancer stressful and find it is causing you significant trauma, reach out to your care team to discuss counseling options for psychosexual issues. You do not need to suffer in silence with this.
Re-establishing your intimate connection.
If you have spent time during cancer treatment in the patient / caregiver dynamic, it may take time to build sex and intimacy back into a relationship. While many find the love in their relationship after treatment may be stronger than ever, sexual intimacy may need to be rebuilt and re-established.
Once you have taken time to feel confident in what you enjoy and feel comfortable with, you can feel empowered to share this with your partner to make your intimate moments more pleasurable for both of you. Here are some other ways to work on establishing intimacy:
- Communication is an essential part of rebuilding intimacy. Find the confidence to discuss what you both want and work out steps to establish closeness and connection.
- Pick a time for discussion away from the bedroom. Avoid discussions right before bed or before you’re about to have sex or initiate intimacy.
- Sex is a form of intimacy, but there are other ways to rebuild a connection or strengthen a bond. It could include date nights, kissing, hand-holding or gentle touch. Check out our blog on ways to keep romance alive in your relationship.
- Don’t judge yourself or your partner and be patient in the process.
- Set aside quality time for intimate moments, taking the time to check in with each other and be honest about what you are both feeling and enjoying.
- Try to keep an open mind about alternative ways to give and receive sexual pleasure. It can be difficult to come to terms with sexual dysfunction, but finding alternative ways to be intimate, is essential if you want to enjoy a satisfying, sexual relationship.
Breaking the taboo of discussing sex and intimacy
Intimacy and sexuality are an essential part of being human and shouldn't be abandoned or neglected just because you have had cancer. If you are struggling with sex and intimacy after cancer treatment then you might feel that ‘this is how it will always be now’. Although it might feel awkward and embarrassing to discuss these concerns, you do not need to suffer in silence and it does not need to be like this forever.
If we start to talk openly to our doctors, therapists, partners or support groups, it would help to break down the taboo of experiencing sexual difficulties after cancer treatment. There is help out there, but health care professionals will not be sitting there waiting to signpost you to support.
The enjoyment of sex and intimacy is fundamental to being human. While this does not have to change after cancer treatment, maybe we need to find new ways to experience pleasure and redefine an altered version of intimacy unique to our needs and desires after cancer.
