Sexuality

Common Problems With Sexuality: Impotence, Gynecomastia, Loss of Libido, Vaginal Dryness, Vaginal Infection, and Genital Pain

Sexuality and Chemotherapy

Intimacy and sexuality are very important to us as human beings. We all need to love something, whether it is a pet, a child, a family member or a friend. We all hope for the love we give to another will be returned. Intimacy and sexuality are intricate- being emotional and physical in nature. We need to feel good about ourselves, with good self-esteem, and be physically able to perform acts of intimacy.

While you are receiving chemotherapy cancer treatment, the way that you define yourself, and your sexuality, may be challenged. This is a normal part of adapting to what is going on in your body, and environment.

Chemotherapy may cause many changes to your body image and self esteem, with both physical and emotional changes occurring at the same time.  It is okay to explore your feelings, alone and with your loved ones.

Ways that Chemotherapy and cancer may affect our outlook on our sexuality includes:

• Hair loss - One common problem is the partial or complete hair loss that may occur with treatment.   This may have a profound psychological impact on ones ability to feel "sexy" or desired by a partner.  Hair loss may occur not only on the head but the entire body including arm, leg, facial and pubic hair. 
• Weight gain or loss - A common side effect of treatment is weight gain from steroid medications or weight loss from lack of appetite. This may contribute to one having a negative self- image. 
• Other side effects of chemotherapy - Many side effects of treatment including, nausea, pain or depression may have a negative impact on your ability to feel intimate. 
• Fatigue, pain or sleep deprivation - These are all frequent side effects of cancer, and cancer treatment. These are commonly affecting patients with cancer as a result of therapy, or a result of your disease
• Trouble breathing, or a long-term cough - From lung tumors, or tumors near your chest area.
• Constipation, diarrhea, colostomy bags, fistulas or open wounds all may lead to a decreased desire for sexual relations
• Swelling from your lymph glands after they were removed, or due to certain cancers (lymph edema)
• Decreased blood counts, or current infections will place you at risk for illness
• Hormonal - in women, whether your are experiencing post-menopausal symptoms of hot flashes, dryness of your vagina or lack of lubrication as a result of your treatment, usually due to a lack of estrogen, these can all impact your sexual health. In men, as a side effect of chemotherapy, or treatment for disease, you may be deficient in the hormone testosterone.
• Erectile dysfunction (impotence) - this usually occurs following treatment from testicular, penile, or prostate cancer in men

Physical side effects of cancer are not the only ways that your sexuality may be affected. Psychological effects are important as well. These include:

• Anxiety - will I be able to function like I normally did?
• Depression - over your current situation
• Fear - of recurrence, or relapse of your disease once in remission, of being able to perform sexually and "satisfy" your partner. Some women and men may also fear of transmitting cancer, or being "radioactive", following radiation implants, or radiation therapy
• Grief - from your situational change
• Guilt - "what did I do to get cancer? Why did I smoke for so long, when I knew it was bad for me?"
• Feelings of low self-esteem, isolation (like you are the only one experiencing this, and you are all alone)

Things You Can Do:

The most important thing you can do is to share your concerns with your loved ones.  Failing to communicate may lead to increasing emotional and physical distance between you and your partner.  A loving and concerned partner may easily alleviate some of the fears you have.  It is important to communicate your concerns - whatever they may be.

Hormone Replacement Therapy

For Men: Hormone replacement therapy for men did not receive treatment for a hormone - related tumor (such as with prostate or testicular cancer) might be an option. Androgen patches and testosterone replacement may be done under the supervision of an endocrinologist (someone who specializes in hormones).

For Women: If you did not receive treatment for a hormone sensitive tumor, you may also be a candidate for estrogen replacement therapy, to decrease the symptoms of menopause, including vaginal dryness, mood swings and hot flashes. Women of many age groups are driven into menopause by their chemotherapy. Other alternatives for the treatment of postmenopausal symptoms may include antidepressants, or clonidine (an anti-hypertensive agent) therapy.  Natural herbs are not usually recommended, as many of these contain estrogen-like compounds.

• Support groups are valuable ways to meet people who are sharing the same experiences, and may help you to feel less alone. Those who belong to a support group may be newly diagnosed, or in remission for years. You may find that some of your fears are ones that others are experiencing. You may also find some helpful hints for managing your disease.  Ask your doctor or healthcare provider if there is a support group that is right for you.
• Many symptoms of treatment that lead to a lack of sexual desire, including, nausea, diarrhea, pain and depression, can be alleviated or controlled by medications. Discuss your symptoms with your physician or healthcare provider. They may be able to help you.
• For women who are having problems with pain during intercourse, associated with the tightness that often follows radiation therapy, or treatment for vaginal cancer, you may benefit from the use of a vaginal dilator. A dilator will help to slowly stretch the vagina over a period of time. Your healthcare provider can provide a dilator, and material to educate you on how to use the device. 
• Do things to make you feel good about yourself, and how you look. Looking good may help you to feel better. Body image can be enhanced by the use of wigs, scarves, or makeup.  Some people enjoy the use of permanent cosmetics. These techniques allow for eyebrows to be recreated and eyeliner to be placed enhancing or replacing lost facial features.  Make sure to have your permanent make-up applied only by a licensed provider, and with your physician's permission.
• The key is to feel better physically and mentally so that you can enjoy your sexuality.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.