Cancer and sex 101

The impact of cancer on our sex life.

As we shed the taboo and shame around sexuality for vulva owners, we must consider all of life experiences. The ones that impact the way we see our sexual selves and feel in our body. The ones that affect how we find pleasure and consider intimacy. Cancer is a life experience that, sadly, so many of us will come by, whether we experience it ourselves, or through a loved one. We think it’s about time that sexual wellness was included in cancer chat.

Cancer sucks. The physical, emotional, and psychological impact of the disease on the wellness of those that experience cancer sucks. There is so much heaviness, that it’s no surprise a taboo topic such as sexual wellbeing gets deprioritized following a cancer diagnosis. Here, we share some knowledge and advice on sex and cancer.

How cancer treatments affect your sex life.

Cancer is a total ordeal for the body and mind; as Lauren Mahon from GirlvsCancer puts it ‘Cancer ain’t sexy…’. From diagnosis, the experience can have a huge impact on us mentally and once treatment starts it becomes physical, too.

It is not easy to feel sexy, and our sexual selves are put on hold. Amidst everything, sexual wellbeing is often the least of priorities for the medical professionals helping you, so it goes without consideration. It’s well-known that people with vulvas amass a lot of shame and dismissal from discussing sexual health in medical settings, with no real reassurance that it’s something to discuss. This taboo can make it even harder for female cancer patients to ask about the sex stuff, especially when oncologists and consultants have not been trained to discuss this part of our wellbeing. If you feel you’ve been dismissed, ask for a referral to professionals such as psychosexual therapists.

With all that in mind, here are some of the ways that some treatments can impact your sexuality. Knowing these may help you put two-and-two together, or help a partner understand too.

• Surgery & operations – discomfort, pain and direct physical impact on erogenous zones or sex organs depending on the type of cancer such as breast or gynecological, scarring, change in hormones.
• Ports & catheters – worry of pulling, discomfort, pain.
• Stoma bags – discomfort, pain, change in appearance.
• Medication – change in hormones, nerve damage, other typical side effects that come with strong drugs.
• Chemotherapy & radiotherapy – sickness, fatigue, hair loss, change in hormones.

These treatments not only affect the body, but also the mind. Remember, sexual wellbeing is a huge impact on us mentally and vice versa.

• Energy & fatigue – loss of desire, frustration of not being able to have the sex you want due to tiredness.
• Early or medical menopause - for those that menstruate changes in hormones and some surgery can start the menopausal phase of life, with that comes hot flashes, migraines, vaginal dryness.
• Depression – feelings of sadness and anxiety, as well as antidepressants taken to support mental wellbeing.
• Pain – painful experiences can leave physical and emotional trauma which makes it harder to find sexual pleasure.
• Vaginal dryness – hormonal changes can impact natural lubrication.

Sex after a cancer diagnosis.

It’s important to recognize that the body goes through a lot of traumas from the point of diagnosis to way beyond final treatments. It’s a lot. And coming back to our sexual selves, at whatever point, is a process. We see and feel our body changing, experience sensations differently and build mental barriers.

‘Our sex lives are not static, they go through changes and stages like everything else, so we should never try and make things ‘go back to how they used to be’ and instead focus on what we can do to make them more satisfying.’ Kate Moyle, psychosexual and relationship therapist.

1. One big mental barrier to unblock is confidence, or lack of. Often, concerns about partner sex and relationships surface, and we can forget to about the relationship with ourselves too. Start with you. Rather than building up shame or putting pressure on yourself through the eyes of others, relieve anxiety through acceptance of yourself.
2. Ask the questions and seek out professionals who can help. If your doctor can’t offer sexual support or dismisses this part of your wellbeing, there are lots of experts out there who will listen.
3. Things might feel different, but that doesn’t mean you’ve lost your pleasure potential! Certain cancer meds can cause loss of sensation, caused by nerve damage called peripheral neuropathy. Erogenous exploration is always encouraged.
4. There are ways to minimize or overcome vaginal dryness caused by the likes of tamoxifen, medical menopause, and chemo. All these shocks and changes have a major impact on the hormones that regulate the vaginal secretions needed for lubrication. It can be painful without sexual activity, let alone with penetration, so opt for more vulval and clitoral stimulation instead. Or, at least to begin with anyway! Lubricant and localized estrogen therapy are go-tos for a lot of the vulva owners in the cancer community. It’s worth noting that penetrative pain can cause psychological reactions too, where our brain sends signals to ‘protect’ us and so the vaginal muscles tighten. This is vaginismus. Pelvic floor specialists can help work through the trauma and offer exercises to help ease the pain.

Some cancers that impact people with vulvas can also have much more specific impacts on our sex life.

Sex after breast cancer.

For many of us, breasts are a big part of how we see and feel our sexual self. Breast cancer can change our perception of them, and surgeries can completely change the look and feel of the chest area. Mastectomies, lumpectomies, reconstruction, or nipple loss are a lot to process – and we may detach from this part of our body completely. Beyond ‘feeling’ our sexual selves, we may also struggle with the change in sensation if we enjoyed breast stimulation.

Sex after ovarian and cervical cancer.

Certain procedures involve the removal of parts of the internal sexual anatomy, such as the cervix, ovaries, fallopian tubes, uterus, and vagina. For many vulva owners, this can mean rethinking penetration. Stitches and scar tissue from these surgeries can cause discomfort during internal stimulation such as intercourse with a penis-haver, whilst in other circumstances it may not be an option at all. Ovarian cancer and other gyneacological ones directly impact the sexual anatomy we’re taught about at school and leave us feeling lost for other ways to connect with our sensual selves.

Reclaiming sexual pleasure after a cancer diagnosis.

If you want to resume sexual activity after a cancer diagnosis, where do you start? These tips are here not to encourage you to force yourself into it, but rather to invite you back to your sexual self. A lot of sex and cancer advice is centered around couples, but hello… our sex life is bigger than just shared experience. We encourage vulva owners who have had a cancer diagnosis to prioritize your sexuality and reconnect through self-pleasure. Take time for yourself, before thinking about taking it with a partner.

Ways to reconnect with your sexual self.

• Take a moment every day to massage or caress your body to gradually regain sensations and familiarize yourself with touch. Your body has certainly been the source of great pain, but it also has wonders of pleasure in store for you.
• Develop your imagination by (re) discovering the creativity of erotica: stories, audio, drawings, films ... Your brain also needs to be rewired and stimulated after the trauma.
• Use affirmations to empower yourself. Small reminders such as ‘I am deserving of sexual pleasure.’ written or post-its or used as a phone background can help us build confidence. These personal declarations are about being honest with yourself, not adding pressure. Don’t feel like you must love your body – it’s been through something huge and accepting where you’re at fights the shame.
• Explore. Your body has changed, maybe your tastes too. Stimulate different erogenous zones or try different techniques you may never have considered before.
• Don’t neglect your comfort. A quality water-based lubricant will improve the sensation and decrease friction.
• Above all, go at your own speed and respect your desires. Don’t rush if you don’t feel ready, and likewise, if you feel ready don’t hold back.

Ways to reconnect with a partner.

• Remember, your pleasure is a priority – and focusing on it can contribute to a more positive partner experience post-cancer diagnosis. Don’t rush physical intimacy with a long-term partner, new partner, or casual partner!
• Talk about it. Of course, it takes two (or more) to tango – and you may also be worried about how a partner feels, and vice versa. Your partner may be aware of the impact cancer has had on you and be scared they might harm you. They might be a new partner, who doesn’t know about how you feel yet. Keeping communication open can help ease lots of anxieties that you all may be feeling.
• Manage the expectations between you. Explain to your partner what’s changed for you; it can be in a fun and playful way, through a show-and-tell of your new erogenous zones maybe. Be open about what sensations you’d like to feel.
• If you’re the partner of someone who has had a cancer diagnosis, encourage a space to talk before getting physical, ask ‘what do you want – how can I support’. Build up a sensual and sexual relationship that doesn’t start with physicality. Sexting, erotica, dirty talk… these can all help bring you closer together. Mutual masturbation is also super pleasurable way to do partner sex without even touching each other.
• For many of us, a cancer diagnosis might not be visible under wigs, clothes etc. Being naked might make us feel vulnerable at first. For others, cancer might be completely invisible. These circumstances can cause us confusion or worry about when to, if at all, disclose your situation. Be kind to yourself and acknowledge that this is a completely annoying normal thing to be thinking about.
• Access professionals! Ask your consultants for advice on where to find sex therapists, or head to a community that can point you in the right direction.
• If your partner has a penis, but internal stimulation isn’t something you want to do / can do, try replicating penetration with lots of lube in other places such as between the legs or boobs. Not only can this be a sensual way to explore different stimulation, but also allows for clitoris play for you too!

Preventative: sexual wellbeing and cancer.

Not only does sexual pleasure play an important role in reconnecting with ourselves and then with partners, but it can also act as a therapy tool for escapism post-diagnosis. What about before? Is there a link between cancer detection and masturbation? Or, even, prevention?

Prevention.

Whether through masturbation or sex with a partner, many studies have suggested a link between having an active sex life and a lower risk of developing breast cancer.

Indeed, one study showed that women who have sex at least once per month are less likely to develop breast cancer (remember, sex can be solo or partnered). This is due to the increase of two hormones, oxytocin and dehydroepiandrosterone (DHEA), both released during arousal and orgasm. DHEA is a powerful chemical that helps to strengthen the immune system.

Detection.

Technical studies aside, masturbation is a superb routine for cultivating a healthy and caring relationship to our own body. Of course, general wellbeing can have an environmental impact on the circumstances surrounding of cancer occurrences. Plus, touching ourselves frequently means we get to know our bodies. The more familiar with what our own normal is in certain erogenous zones, the more likely we will know when something feels not quite right. Feeling our boobs or embracing vulva pride can prompt early diagnosis, and therefore save lives!

‘Knowing what your vulva feels like won’t just get you off, it will also help you spot the signs of cancer. Taking five minutes to feel for any lumps, sores, raised and thickening skin, tenderness or moles changing in shape, is just one of the ways to check in on your gynae health.’ @LadyGardenFoundation

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