How to Reclaim Your Sex Life After Cancer

The Sexual Side Effects of Chemo and Surgery

Couple together in bed
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Sexuality and intimacy probably aren't at the top of your list if you're grappling with an upcoming cancer treatment, but they represent one way to ease anxiety, release stress, and help you recover. It's important to recognize what's possible. Some treatments have more of an impact on your sexuality than others.

Acknowledging the possibilities may also empower you with the information to help you decide between treatment options.

Ultimately, being prepared will allow you to see the light at the end of the tunnel towards living life normally again. It might also motivate you and help you keep your eye on the prize.

Cancer Treatment Side Effects

Ovarian cancer treatment can cause physical changes to your body that can be lasting or temporary.  These changes can affect your overall body image, which is often due to the perceived changes inside your body. In turn, your psyche and emotions are affected, usually related to the hormonal imbalance caused by treatment.

But what are the most common side effects you can expect? The possibility and the extent of side effects hinge on what type of treatment is planned. The following side effects are quite common and the most likely to occur:

  • loss of desire
  • difficulty achieving an orgasm
  • shortening or narrowing of the vagina
  • painful intercourse
  • vaginal dryness

Keep in mind that not everyone will get every single one of the aforementioned side effects.

These are simply the possibilities. Some will experience none, while others may have a lot of associated problems. Sometimes the side effects are brief, while others are lifelong.

Chemotherapy Side Effects

Chemotherapy is typically injected into the vein, and it affects the entire body. Loss of libido, or desire, is very common during chemotherapy.

Of course, it's difficult to feel desirable and want intimacy if you feel nauseated and your hair is falling out. Luckily when chemo-related side effects dwindle, these sexually related side effects generally improve. However, the psychological shock of body image alternation can persist, and it may take some time to regain those feelings of sensuality and a desire for closeness.

Physically speaking, chemotherapy affects the ovaries, which produce estrogen and testosterone. If the ovaries have been removed or if you are menopausal this won't add to the problem, but in some early stages of ovarian cancers, only one ovary is left behind.

Depending upon the type of chemotherapy you receive, there can be a temporary or lasting disturbance due to the lack of hormonal output. Diminution in hormone levels may cause flushes, soaking sweats, mood swings, loss of desire, and vaginal dryness. In turn, vaginal dryness can cause painful sex. Depending upon the type of cancer you have — hormone-sensitive or not — hormonal replacement therapy can be prescribed.

This may include both estrogen for menopausal symptoms and testosterone to increase libido.

If the cancer is estrogen-sensitive, however, it's generally not a good idea to consume estrogen. Still, there's no medical proof that estrogen replacement in ovarian cancer impacts survival. There are also weaker bio-identical hormones available from plant sources.

This is a challenging issue that affects everyone differently, so it's best to discuss your situation and options with your doctor.

Surgery Side Effects

Ovarian cancer cytoreductive surgery typically calls for the removal of quite a few organs in the pelvis. It might include just the uterus and ovaries, or part of the rectum as well. But in spite of the surgical measures taken to prevent this, such as putting the omentum in the area behind the vagina, after this part of the bowel is removed, there is no shock absorber behind the vagina.

The vagina can fall backwards in the pelvis and get stuck to the muscle and bone. This results in painful intercourse that may require a change in sexual habits and positions to make the angle of penetration more comfortable. If the ovaries have been removed and you've not experienced menopause, these same symptoms can occur.

Occasionally, only the partial removal of the intestine/rectum is required and the two ends are reconnected, averting the need for a colostomy bag. The closer the removal of colon/rectum is to the anus, the greater the chances of needing a colostomy bag. Clearly, this is a major body image change, and the emotional side effects regarding sexuality are important to address. Even if a colostomy is needed, there are ways to avoid a bag by "training" colostomies to be dry, among other alternatives.

How to Cope With Sexual Side Effects

Talk with your doctors and healthcare team. There's no reason to feel shy, embarrassed, or awkward about talking to your doctors about these issues. Your goals and interests might sway your decision to choose one treatment over another. For example, a radical surgical procedure and chemotherapy as well as a less radical surgery can be equally effective, but their impacts on sexuality may be quite different.

You should absolutely be in the middle of this decision-making process. There are also nurses and counselors available to address sexuality and intimacy issues before they become a permanent problem. Find them. Talk to them.

Talk with your sexual partner. Your partner should be closely involved in helping you make decisions, cope, and recover. By working together you can explore the remedies, lubricants, dilators, and other devices to regain your sexuality. As previously mentioned, some sexual habits and positions might need to be altered. Tackling this together can be a growing experience that will bring you closer together.

Experiment with intimacy. There are many ways to be intimate other than vaginal intercourse. Clitoral stimulation, oral intercourse, anal intercourse, and sex toys are all satisfying alternatives. Caressing and cuddling are not to be discounted either. The idea is to explore, reduce anxiety and stress, and reinvent your intimate connections.

Seek out cancer survivors and support groups. These days you can talk with support groups and cancer survivors face-to-face or online. You'll be able to find relief in knowing that survivors are able to bring intimacy and sexuality back into their lives.

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