Sexual matters
Topics covered on this page:
How does this affect me?
A cancer diagnosis and undergoing cancer treatment may cause you to feel uncertain, stressed, or worried–sexuality is likely not at the top of your list of priorities at this time. Your body may experience changes that affect your self-image, feelings of sexual desire, and how you connect with your partner. Thoughts and feelings about cancer may interfere with your enjoyment of sex.
Here is a list of some of the physical and emotional changes you might experience during treatment that could affect your feelings about sex, sexuality, and intimacy:
Physical changes:
- Low energy or fatigue
- Pain or discomfort during sex
- Vaginal dryness (women)
- Problems with erection function (men)
- Lack of desire/interest
- Sensitive skin
- Urinary incontinence
- Decreased arousal
Emotional changes:
- Anger
- Feeling emotionally numb
- Embarrassment
- Anxiety
- Fear
- Sadness
- Lower self-confidence
What can I do to improve my experience of sex?
Your sexual health is an important part of your overall sense of wellbeing. Although you may find it hard to deal with this subject during treatment, it is important not to ignore it. Our society promotes an unrealistic view of sexuality that is full of young, healthy, fit and active people. You are bound to be disappointed if your expectations are taken from this stereotype! In this model, the woman never needs to decide whether to wear her wig for lovemaking and the man is never concerned about his ability to have an erection.
A helpful exercise for you, rather than compare yourself to unrealistic standards, could be to ask yourself a few simple questions:
- What were your top three assets as a lover before the cancer diagnosis?
- What are your top three assets now?
- If you feel you have lost some important quality—have you gained something in its place?
Consider confronting cancer as a reminder to enjoy each day! Try talking to your partner because this is the first step in recovering a satisfying sex life. To help maximize enjoyment from your sexuality, here are a few strategies that may help:
With a cancer diagnosis, treatment schedules, and everything else to manage in your work and family life, it may seem impossible to find time for sex. That is why it is important to schedule your private leisure time with your partner.
- Schedule mini-vacations for an evening or afternoon with your partner—or even a couple of hours after the kids are in bed! Don’t try and plan a whole vacation, as this can just add more unwanted pressure.
- Enjoy transition time before starting your mini-vacation, to put aside your daily life. You may want to read a book for half an hour or take a bath.
- Choose a place and time where you are unlikely to be interrupted. Turn off the phone and let the answering machine take any calls.
It might not be realistic for you to engage in intercourse at this time, either because of your cancer or treatment side-effects. There are, however, other ways to get close to your partner during this time:
- Try rediscovering making out. You can agree with your partner what your limits are, whether it is kissing on the couch, caressing with your clothes on or exchanging orgasms through hand caressing.
- Water can be a relaxing environment. Consider a sensual shower or bath with a partner. Music and soft lighting can help set the mood.
- Dancing to your favourite music can build a romantic or sexual mood. The activity will help increase your pulse and deepen your breathing—physical cues that feel a lot like sexual excitement.
- Touching your own body will let you know what feels good to you, without worrying about a partner’s pleasure. If it gives you pleasurable feelings, you know that your sexual response is still working! You may discover that touch feels different since your cancer diagnosis and treatment. You can teach your partner how to alter the way they touch you.
For some couples, talking about sexual health can be difficult. You may feel embarrassed by the changes in your body; however, it is important to talk openly with your partner about how cancer is affecting your relationship.
- Write down a list of your concerns to help get the conversation going. You can start by saying what negative emotions you feel, and how you feel your partner can support you.
- Tell your partner if anything causes you discomfort or pain. You can talk about trying different positions that may be more comfortable, such as side by side positioning to reduce pressure on a sore area, a scar or stoma. Pillows and cushions can also provide support and comfort.
As your body changes, you may need to change or adjust the way you approach sex by:
- Being open to trying different sexual activities and techniques.
- Showing affection and intimacy in other ways, such as cuddling, holding hands or hugging.
Treatment side effects can interfere with all aspects of your life, including your sex life. Managing side effects that affect your sexual health can help improve your experience in this area.
- Some cancer treatments cause vaginal dryness for women, which can lead to pain or discomfort during intercourse. Vaginal lubricants, moisturizers or creams may help make the experience more comfortable.
- If pain or nausea is interfering with your ability to become aroused or to have sex, talk to your doctor about how you can take your medication to best manage these symptoms with sexual activity. It is hard to get in the mood for sex if you feel miserable. Your doctor might suggest taking your medication at a certain time before you plan to have sex.
- Fatigue is one of the most common treatment side effects. If you feel too tired at the end of the day to even think about sex, try putting aside time for intimacy or sexual activity at the beginning of the day or when you know you’re usually less tired. You might also try taking a nap before sex.
- Some women may experience urinary incontinence. Pelvic floor exercises may improve urinary retention.
When should I get help?
It is normal to feel overwhelmed by cancer-related changes. Although the tips in the sections What can I do to improve my experience of sex? and What can I do to look after myself? may help improve your experience with sex and your overall sexual health, you should contact your healthcare team immediately if you experience any of the following situations:
- Bleeding after sexual activity (women)
- Pain during sexual activity that changes or worsens
- You, or your partner, notice that you are becoming depressed
- You feel that you are unable to cope on your own
Where can I find help?
Try to get help for your sexual health concerns early to avoid unnecessary stress and discomfort:
- Ask your doctor to recommend a sex therapist. A sex therapist might be able to help you work through the emotional and physical sexual problems associated with cancer and cancer treatment.
- Make an appointment to speak with a counsellor or psychologist. This kind of professional may be able to provide you with concrete advice on how to manage any issues in your sexual relationship.
- Join a support group. It can be easy to forget that you are not alone in your sexual health concerns. Many couples and singles experience similar issues during cancer treatment, and talking to others can often provide great support.
- The Quebec Cancer Foundation provides a resource directory where you can search for the organizations near you offering a variety of services including home help, lodging, transportation, and other supportive resources.
What can I do to look after myself?
In addition to managing treatment side effects, there are a number of things that you can do that may also help improve your sexual health. Below are some suggestions you can try.
Tracking your treatment side effects and symptoms can help you understand more about what is interfering with your sexuality. A symptom diary is also a useful tool to use when discussing symptom management with your healthcare team. A symptom diary should include information like:
- What makes your symptom better or worse?
- When does it usually occur?
- How long does it last?
- For more information see Symptom Diary.
Getting a good night’s rest can help reduce fatigue and improve your energy levels. You may then find it easier to think about, and plan some time for, intimacy and sex.
- Develop a sleep routine. Try to go to bed and wake up at the same time every day. If you do take a nap during the day, try to limit it to 20-30 minutes.
- If you are having trouble sleeping, before going to bed, try doing an activity that you know relaxes you, such as listening to music, reading or meditating.
- Avoid caffeine and sugary drinks in the evening.
- It’s recommended that you turn off computers and tablets at least one hour before you plan to go to bed—the bright screens of these devices can trick your brain into thinking it’s daytime and make it hard to sleep.
Relaxation strategies can help relax your mind and body, and reduce the negative feelings that you may feel surrounding sexual activity. You can try some of these strategies on the go, as well as at home. For more information see Relaxation Strategies.
- Meditation: The practice of meditation can bring about a deep state of calmness. Meditation involves quieting the mind, usually by focusing attention on the breath. You can meditate sitting, lying down and even walking.
- Guided imagery or visualization: This technique involves imagining or visualizing a place that makes you feel calm. You can be guided by someone on a recording or in person.
- Progressive muscle relaxation: This involves tensing and relaxing a muscle, or group of muscles, one at a time.
- Breathing exercises: This focuses on slow, deep breathing. Taking a moment to take deep, slow breaths can calm your whole body.
- Heat therapy: If you find yourself feeling tense before sex, try taking a warm shower or bath first to help you relax.
Resources
For more information on sexuality and intimacy in cancer, check out the resources below.
Canadian Cancer Society – Sex and intimacy
Leukemia and Lymphoma Society – Coping with cancer-treatment effects on sexuality
University Health Network – Your emotions, body image and sexual health
BC Cancer – Sexual health concerns and care
Coping Together – Guide for couples facing cancer- getting on top of symptoms
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- BC Cancer. Sexual Health and Cancer. 2019.
- Canadian Cancer Society. Sex, Intimacy and Cancer. 2018.
- Cancer Care Ontario. Interventions to Address Sexual Problems in People with Cancer. 2016.
- Coping Together. Getting on Top of Symptoms. 2013.
- Leukemia and Lymphoma Society. Sexuality and Intimacy Facts. 2016.
- Schover LR. Sexuality and fertility after cancer. 1997.
- University Health Network. Breast Cancer Your Emotions Body Image and Sexual Health. 2019.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
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