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Why It Can Be So Hard to Have Sex After Cancer (and What to Do About It)

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Most people probably assume maintaining your sex life while undergoing cancer treatment would be a challenge. Between treatments, stress, side effects and fatigue, sex is likely often off the table. But once your treatment is over or you enter remission, it might seem like your sex life should bounce right back. Because cancer is “over,” right? So why would that part of your life still feel like it’s on hold?

It’s not unusual at all for sex to be challenging after cancer, for many reasons. Gretchen Kubacky, Psy.D., a health psychologist from Los Angeles, told The Mighty physical and emotional factors can make sex after cancer difficult. For example, cancer may cause residual fatigue, scars or burns from treatment, shame or embarrassment about your changed body, reduced libido (sex drive) due to chemotherapy, lack of interest because of depression related to having had cancer or heightened anxiety about your body not working well, having pain, or experiencing other pain or awkwardness related to a “damaged” or “broken” body.

“It may also be affected by a partner’s lack of interest, fear of hurting the cancer patient, or relational changes as the partner transitioned from lover to caregiver during the cancer,” Kubacky said.

In short: your body and mind went to hell and back, so it’s only natural that you’re still feeling the effects and not quite “in the mood” like you were before.

To get more insight into why sex after cancer can feel like a minefield of physical and emotional challenges, we asked our Mighty community to share how cancer has affected their sex lives. Read their responses below, plus Kubacky’s advice for both survivors and their partners.

  1. “Our sex life changed drastically after my first diagnosis. Like others have said, your body doesn’t feel like your own. I’m fighting again 10 years later and with all of the health issues I have had in between both cancer diagnosis, I’m always feeling like a patient, not the wife/caregiver/lover I used to be. Not to mention the additional pounds I’ve gained. Ugh, I just want to go back!” — Laurie R.
  2. “My body is forever altered. My bilateral mastectomy doesn’t make me feel the same, my nipples were removed and that is a very sexual area for most women. They will eventually be tattooed back in but it’s never the same personally. Forever altered.” — Sarah C.
  3. “[It’s difficult] feeling like a sexual human being instead of a patient. I still don’t feel like my body is my own. Plus, my husband and I are having trouble moving back to husband/wife rather than patient/caregiver. And we’re afraid of pain due to graft versus host disease from my bone marrow transplant. This has been bothersome for me because I’ve never had problems with sex before. Now, I have trouble being touched at all. I feel broken.” — Elizabeth M.
  4. “As the years go by, for me, it’s harder to feel sexually alluring. I had a bilateral mastectomy/oophorectomy 20 years ago, and six years ago, I had to undergo a DIEP flap, which changed my belly area forever, as well. Sigh. Thank God my husband loves me and truly understands.” — Debbie B.
  5. “Among the countless ways in which cancer impacts one – both physically and emotionally – is in that most sensitive of realms: the bedroom. Although I, fortunately, was not physically impaired by cancer or undergoing chemo, mentally I have been scarred by the experience in a way that directly – and negatively – altered my perspectives on sex. The root of the problem is that cancer can make one question her or his physical integrity in deep and profound ways. This undermining of one’s sense of physical well-being makes it quite challenging to feel positive about oneself when in the most exposed physical activity in which most of us can engage (if we are lucky).” — Jeff N.
  6. “There are many challenges surrounding sex after having cancer treatment; they can be both emotional and physical. Emotionally you have changed; your focus has moved from living to fighting to stay alive which leaves little thought for sex. Physically you have changed, too. Sex may now be painful causing more anxiety than pleasure. Cancer treatment also has a way of stealing your libido: it seems that all of your energy is now expended just getting through the day. As time goes on, hopefully, these challenges will be overcome.” — Michele T.
  7. “So much of cancer is an exercise in letting go of control, in being at the mercy of doctors, caretakers, meds, etc. It’s a natural instinct to shut down the sexual advances of your partner if only because it’s one of the few things you can control. But, assuming your cancer is one that allows you to still do so, having sex is an amazing way to connect with your partner. Furthermore, it’s a way to remember your body is capable of feeling so much more than just fear and pain. Intimacy and connection are worth fighting to keep.” — Elly L.
  8. “Sex, intimacy, and cancer are not things that fit together very nicely for many people. For some potential partners, it might be the knowledge that Cancer (capital C) is the unspoken elephant in the room; for others, it might be the knowledge that the scar that goes from stem to stern is a constant reminder of the fact that this journey may never be over. For the patient, it is often difficult to muster libido, something that changes with medications and mood, just as it is difficult to control the body’s willingness and reaction to side effects of treatment. For me, still a patient undergoing active treatment and still alive, my scar is a track down my abdomen, a reminder, a constant whisper of being alive. It is when I have found someone who can revel in that whisper with me that I can allow myself to breathe more fully and open myself to the possibility of intimacy and what comes next.” — Kelsey B.

If you are struggling to restart your sex life after cancer, first, remember that there is nothing “wrong” with you. What you’re going through is completely normal and something many cancer survivors experience. That being said, there are a few things you can do to start to move through any physical and emotional roadblocks. Kubacky recommended first acknowledging the difficulties and identifying what the source of the problem is. Then, discuss with your partner, if you have one.

You should also consider joining a cancer-related support group or seeking psychotherapy. Don’t hesitate to bring it up with your doctor as well.

“It may also mean that, while the physical experience of being treated for cancer is over for now, there are other aspects of physical or mental health that need tending and nurturing,” Kubacky said.

Partners, keep in mind that libido naturally drops during cancer treatment as a person is focused on survival, and it usually takes a while for a cancer patient to feel safe enough to resume sexual activity, Kubacky said. Be patient with your partner, take things at their pace, and reassure them that you still find them attractive and that you love them regardless of the changes to their bodies.

Offer to make adjustments for their comfort, such as shifting positions, changing the time of day, and adding lubricants or toys. And if you’re having trouble reimagining your sex life, look for a therapist who can help you redefine it together, in a way that works for both of you.

“Just acknowledging that it’s difficult right now, but you’re in it with them and want to please them as much as possible can be a good start to getting back on track sexually,” Kubacky said.

For more insight into sex and cancer, check out these stories from our Mighty community:

What’s an aspect of sex after #Cancer that doesn’t get talked about enough?  #Lifeaftercancer

Getty photo by monkeybusinessimages

Originally published: August 5, 2019
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