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Colorectal Cancer: Sex, Sexuality and Intimacy

Tips For Having Sex During And After Treatment

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Tips for having sex during and after treatment are divided as follows:

  • For men and women with colorectal cancer
  • For the partner
  • For a couple 

For The Man Or Woman Diagnosed With Colorectal Cancer

  • Before engaging in any intimate activity, feel as comfortable in your body as you can. 
  • Get to know your body again. Find out what feels good, what feels bad, and what you feel safe doing. For example:
    • Consider self-stimulation if it is acceptable with your own and your religion’s belief system. Self-stimulation can enable you to regain sexual interest if you are too tired to have sex with a partner. It can also help you learn what is pleasurable, so you can share the information later with a partner.
    • Get into a bath or shower and spend 15 or 20 minutes to gently feel and massage your body. Find out what feels good, what feels bad, and what you feel safe doing.
  • Go to a day spa or spend the day pampering yourself. Rebuilding a connection with your body helps to reconnect not only with your body but with other people.
  • Rest during sex or sexual play. Sex is not a marathon. You are there for each other.
  • If your interest in sex has changed, you can retrain your body to remember what it used to be like to be aroused. For example, you can fantasize about what it was like to be aroused at an earlier period in your life.
  • Consider teasing exercises with your partner throughout the day. For example, leave notes for each other or text messages. Reduce the lighting and light candles. 
  • If anti-depression medications are causing low sexual attraction, there may be a medication that does not have the same side effect. You will not  know for sure until you try. Talk with your doctor or mental health therapist. 
  • When you are able to, reconnect with your social life. If necessary, adapt your social life to meet your needs. For instance, ask friends to come join you. If nothing else, have friends over for tea or to watch a movie.
  • Exercise to the extent that you can. Exercise can make you feel better about your body and enhance your mood. (For information about exercise, click here.) 
  • Men:  If you are concerned about desire, erection and/or performance, there are several options including:
    • Medication such as Viagra and Cialis. They are not right for everyone. For instance, these drugs do not address depression or anxiety. For information, speak with one of your doctors.
    • Assistive devices such as a pump or vacuum.
    • To learn more, see our document about Erectile Dysfunction.   
  • Women:
    • Moisturizing the vagina is important.  On a daily basis, consider using 100% Vitamin E oil to help with reconditioning your vagina and with moisture retention both internally and externally. Vitamin E is natural. It helps with softening skin and scar tissues. Use it inter-vaginally and on the labia. (Do not use Vitamin E as a lubricant during sexual activity . It is sticky.)
    • Warming creams and clitoral heighteners can help with increasing blood flow which heightens sensitivity.
    • The web site PureRomance has a “S.S.S Program” to help women with breast cancer recapture their sensual and sexual selves. Information on the site can be helpful for women with colorectal cancer.. The program includes individuals trained as consultants to help women learn about safe products which can help enhance their sexual experience. The site also provides information about how to choose the best product for your needs. PureRomance also sells items that you may not feel comfortable going into a sex shop to buy. The shipping box is nondescript. See www.pureromance.com/sss offsite link.
    • If there is a change in your vagina, talk with your gynecologist about exercises that may help.
    • If you are having a difficult time climaxing, try moaning and groaning. (Remember the scene in the Movie: When Harry Met Sally?) Moaning and groaning creates a kind of vibration in your body which may help you peak.
    • If you are having difficulty climaxing because of vascular changes that can happen from pelvic radiation, consider using a small clitoral vibrator. You can control the speed. Sometimes, all you need may be  faster stimulation than your partner Is able to provide. 

For The  Couple Sharing a Diagnosis of Colorectal Cancer

  • If you haven’t engaged in sexual activity in a while, it is better to start slowly. Starting slowly will provide a way of being physically close and intimate without pressure and anxiety:
    • Use non-sexual touch and massage to stimulate closeness.
    • Focus on parts of the body that do not cause distress.
    • Stay away from genital touching during the first weeks of engaging in these exercises.
    • Experiment with different positions. It may help decrease anxiety.
    • As Dr. Sage Bolte says: “Communicate, Communicate, Communicate… We don’t read minds!”
      • People are often shocked to find that their partner doesn’t start sexual play because of reasons like “I don’t want to be selfish.” “I don’t want to hurt you.” “I didn’t think you were interested.”
      • To communicate, state a fact, a feeling or belief, and an action. For example: 
        • A fact: Ever since my cancer diagnosis, we stopped cuddling and having sex at night. 
        • A belief: I believe you are not attracted to me any more. 
        • A feeling: This makes me feel sad. 
        • An action: What I need is for you to cuddle with me at night, or reach out to me at least once a week for sex. 
  • To help work through road blocks, see a mental health therapist or a sex therapist . To find a sex therapist, speak with a social worker at your cancer treatment center or contact  the AmericanAssociation of Sex Educators and Therapists by clicking here offsite link. For information about the types of mental health therapists, click here

Keep in mind that any marital or relationship problems you had before the diagnosis don’t go away just because of a diagnosis. They may go underground for a while but they are likely to bubble again after treatment ends. If the two of you cannot handle these issues yourselves, consider speaking with a mental health professional.

For the Partner

  • Communicate about your own desires. This is not selfish or insensitive. 
  • Be honest. 
  • Ask your partner:
    • What he or she would like to do
    • What he or she would like you to do. 
  • Show affection in a relaxed way. For instance: 
    • Reach for his or her hand 
    • Rub the back of his or her neck 
    • Grab the knee 
    • See a romantic comedy together 
    • Touch each other 
    • Schedule time with each other. Think about having a date (as compared to your patient/caregiver roles).
    • Take a weekend trip to celebrate end of treatment or to reconnect – even if all you do is sit and play cards and laugh and massage each other’s feet.  Sex or intercourse does not have to be part of it. Get back to the pleasures of touch and intimacy.
    • Show affection in a relaxed way so your partner knows you are still interested and that he or she is not being rejected.
    • Do what you can to stay positive. That does not mean not talking about your concerns or fears. You can do both. For suggestions about how to stay positive, click here
    • If you have questions, ask your partner and/or the health care team. If you are concerned about asking a doctor for sex information in front of other people, ask for a few minutes of private time with the doctor or his/her nurse.

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