Sex And Intimacy
In addition to pleasure and gratification, sex has a variety of benefits including improved mood, stronger immunity, and reduced pain.
Sexual issues are not uncommon in the new normal that exists for the rest of life after a diagnosis. Rather than not have sex or intimacy, the way you have sex or express intimacy may need to change for a while or permanently.
Sexual issues can arise from:
- The emotions that come with a diagnosis or living with a health condition.
- Physical changes resulting from the condition.
- A treatment such as surgery,chemotherapy, or radiation.
- Medications to treat the disease or emotions. For example, anti-anxiety drugs.
Keep in mind the following:
- Sex is only a part of sexuality and of intimacy. It is not the only way of having intimacy with another person. For some people, sex is only a small part.
- Intercourse is not the only satisfying sexual activity. For example, cuddling and kissing with someone you care about and who cares about you can be very satisfying.
- Sexuality is about a lot of things including:
- The way we think about ourselves as sexual beings. It involves both physical and non-physical parts and is different from person to person.
- The clothes we wear, the way we move, the way we have sex, with whom we have sex and even cultural and religious beliefs about sex.
- Sexuality is different from Intimacy. As a general matter, intimacy is the sharing of our innermost thoughts and emotions. Intimacy can involve sex and/or touching, but it doesn’t have to.
- How we think about ourselves as sexual beings influences our behavior. If we have negative feelings about ourselves, we are likely to feel down and withdraw from other people – even from a partner and children.
If you have cancer and are in treatment, as a general matter, you can have sex during treatment. However, it is advisable to always check ahead of time with the doctor who is overseeing the treatment. Sex during treatment is not recommended if:
- Your immune system is low (“immunosuppressed”)
- You have very low blood counts
- You are in the first weeks of recovery after surgery
- You have an ostomy
If sexual or intimacy issues are a concern:
- Involve your partner.
- Communication about your needs and concerns is critical.
- The best communication is to state a fact, then a belief, then a suggested action.
- If your partner is not interested in sexual activities, perhaps there is an underlying fear or anxiety that can be reduced or eliminated with communication. If not, there are steps to take. For instance, consider cuddling plus self pleasure.
- To learn how to involve your partner, click here.
- Be creative. Think about your needs. Keep in mind that skin is the largest sex organ and the brain is the most important sex organ which means that the possibilities are limitless. Communicate with your partner.
- Be patient.
- Keep a sense of humor. A sense of humor is a must. (To learn about keeping a sense of humor, click here.)
- For tips about minimizing sexual issues, click here.
If you don’t find the answer that works for you, speak with your doctor. Don’t wait for him or her to bring up the subject. While doctors consider quality of life subjects important, they tend to focus more on the physical aspects of your condition and/or treatment. Many physical issues can be treated. Your doctor may be able to help you pinpoint the cause of issues you are having. Perhaps a medication can be prescribed or a treatment can be changed. Your doctor may also have suggestions about working through emotional issues.
If sexual issues become unmanageable, consider couples counseling or consult a professional such as a licensed sex therapist who is experienced in dealing with people with your health condition or particular situation. You can find a sex therapist through the American Association of Sex Educators and Therapists, www.aasect.org .
For additional information, see:
- Myths About Cancer And Sex
- How Surgery Can Affect Sexuality
- How A Diagnosis Can Affect Sexuality And Sex Drive
- Men and women:
- If a drug or treatment could render you unable to have children:
- If you are considering undergoing resection surgery, there are exercises known as Kegel Exercises that you can start before surgery to help manage incontinence. The exercises can also be helpful with an erection for men. To learn more, click here.
- If you are considering undergoing radiation or surgery anywhere near the pelvic area, or if you are pre-menopausal and are considering chemotherapy, ask your doctor about starting dilative therapy early to keep your vagina from narrowing (“Stenonsis”). A preventive approach avoids trying to catch up with something that either has scar tissue or has shrunk.
- If you experience stenosis, there are pelvic therapists who are trained in vaginal reconditioning. The odds are there are at least a few such experts in a gynecological practice in every metropolitan area.
The content of this article is based in large part on work by Sage Bolte, PhD, LCSW, OSW-C, Oncology Counselor, Fairfax, VA