What was your first thought when you were told you had cancer? Will I live? How will this affect my family? Will things ever be the same? Whatever your reaction, it’s unlikely that your first thought after being diagnosed with a life-threatening illness was, But what about my sex life?
Going through cancer takes mental and physical stamina, and in the midst of chemotherapy, radiation, and surgery, sexual intimacy may not even remotely be an option. But after treatment, when the dust settles and a woman finds herself looking to reconnect with her partner or looking to start a new relationship, there are a host of new questions to answer. A woman’s post-cancer body will have undergone substantial changes; there might be scarring, tenderness, loss of sensation, or pain. Restarting a sex life can feel overwhelming.
The American Cancer Society says that the ability to feel pleasure from physical touch usually continues after cancer treatment, but it may not be as easy as before. Reestablishing sexual intimacy after cancer treatment is possible but takes understanding, patience, and a willingness to embrace new possibilities.
The Challenges of Sex After Cancer
For someone who’s gone through cancer, the initial challenges are obvious. Treatment makes you weak and nauseated, and it may be painful to move around, let alone have someone else touch you.
But there are deeper issues that emerge. A woman may feel like her body has betrayed her and feel disconnected from herself as if she were living in skin she doesn’t recognize. If a woman has lost one or both breasts, she may have trouble feeling attractive or feminine. Looking in the mirror at scars, weight loss, weight gain, or other changes can make a person want to cover up and hide. Some women grow to see their scars as marks of their strength and find beauty in them, but that is usually not an overnight process.
Self-confidence and body-confidence are linked to sexual desire and pleasure, and lack of confidence may rob a woman of the desire for sex or the ability to enjoy it. And if a woman is in a long-term relationship, her partner will experience stress and uncertainty as well.
A study on the spouses of women with recently-diagnosed (within the past 6 months) breast cancer found that the diagnosis put stress on the couples’ physical relationships. The spouses blamed the change in their sex life on changes in physical appearance, surgical scars and tubes, the woman’s self-consciousness, fear of hurting her, and their own concerns about being able to be physically responsive.
So while a woman is recovering from cancer and trying to make peace with the changes it has made in her body, her partner may be struggling as well. Both partners may be unsure and nervous. But problems will only get worse if unaddressed.
Why It’s Important to Keep Trying
Sex releases endorphins and helps you feel close to your partner, and can improve your long-term relationship satisfaction so long as it grows out of love and connection rather than obligation or coercion.
A study on newlyweds found that greater sexual satisfaction led to greater relationship satisfaction over time, but it wasn’t just the act of sex that strengthened the relationship, it was the level of satisfaction that it provided. That satisfaction sprang more from a strong relationship rather than from sexual prowess: good sex leads to a better relationship, and a better relationship leads to better sex. They build off of each other.
In best-case scenarios, cancer strengthens the relationship because of the trials a couple overcomes together, but it can also cause couples to bottle up their emotions and withdraw from each other. The strain of cancer treatment may exacerbate issues that existed before, and this strain will translate to the bedroom. Physical intimacy alone cannot fix a relationship’s challenges.
How to Talk to your Doctor
First, it’s good to have some practical issues cleared up. When will it be safe for you to have sex again? If you have a low white blood cell count, do you need to avoid intercourse because of possible infections? What about birth control? How might your chemotherapy affect your partner?
These are tough questions, but it’s essential that you have all your questions answered so that you’re not nervous when trying to be intimate. A doctor or nurse may be simply waiting for you to broach the subject—they very likely have talked about sex and treatment before and are more than happy to have a candid, informative conversation. Something as simple as, “How will this affect life in the bedroom?” may be a great starting point. Be brave and get the information you need. For more tips on talking to your doctor, check out this video.
How To Start
If you are going to reestablish or start a new sexual relationship, you must be able to communicate with your partner. It’s tough, and the strain of cancer may leave you both feeling unsure. If you’re in a new relationship, addressing how cancer treatment may affect your sex life could make you worry that your partner will leave you. But the reality is that if you’re not able to discuss sex openly with your partner, it will be difficult to have a completely relaxed, pleasurable sexual experience.
The first step is usually the toughest. Think about what you would like to say and be wary of phrases that may come off as demanding or accusatory. Try not to assume that you know your partner’s feelings or motivations. Try phrases like, “I miss making love to you,” or “I’m interested in becoming more physical, but I have some concerns I’d like to share,” or “I’d like to feel close to you again. What can we do that we’re both comfortable with?”
Make sure to be intentional about when you have the conversation, and be open to rescheduling if your partner is not ready or would like some time to think. The key is to let go of preconceived ideas of how things should be or how things were and be open to what new types of intimacy might work for you as a post-cancer couple. Strict expectations and quotas belong at work, not in the bedroom. Be excited about discovering new ways to feel connected, and always keep a sense of humor. Sex can be awkward and imperfect at the best of times, so have ample grace with both yourself and your partner.
Practically speaking, even if you and your partner have a healthy relationship, you may be nervous about being touched in sensitive or scarred areas, and your partner may be unsure how to touch you without causing pain. Be sure to fully address these concerns. Start the process by working on cuddling, touching, and kissing, and give yourselves permission to take all the time you need. Enjoying physical touch, without sex, can help familiarize each partner with new boundaries and help you both feel comfortable touching each other again.
Practical Advice: How to start touching again
1. Connecting With Your Body Visually
It will be hard to connect physically with a partner if you’re disconnected from yourself. Start by reconnecting with your physical self.
The American Cancer Society suggests spending time looking in the mirror at yourself. Starting with your clothes on, look at yourself and find at least three things you like. Practice this until you’re comfortable and can give yourself three or more compliments easily. The next step is to try the same exercise while wearing something that you might wear with just your partner. Find clothing that fits you well and makes you feel comfortable and attractive. Try makeup or jewelry if you like—whatever makes you feel your best.
Do your best to not get hung up on scars or a bald head. Do you like the color of your eyes? The shape of your ears? Take some time to rediscover yourself in privacy. Finally, try the mirror exercise without clothes on. Let go of what you used to look like or what you think you should look like and learn to love yourself as you are. It may take some determination, but press through discouragement until you are confident talking positively about yourself.
2. Connecting With Your Body Physically
Get to know the new you. In private, touch different parts of your body and see where stimulation is different than it was before cancer. Where do you enjoy being touched? Where does it cause pain? Discovering these things while alone takes the pressure off of pleasing your partner and helps you connect to yourself. Practice this until you are comfortable. Touching yourself in private areas can help you understand where you can feel sexual stimulation and where you may want your partner to touch you, but if you are not comfortable with that, simply enjoy touching other areas of your body. Stroking or massaging helps you to understand and appreciate yourself.
3. Connecting With Your Partner
Once you and your partner both understand that you are on new, uncharted territory, agree to take things slowly on your new journey. Make the goal discovery and connection rather than just orgasm. A woman’s body changes over time, especially after cancer treatment, so be clear that you want to focus on feeling close. Try sessions where you are only touching non-sexual parts of each other’s bodies until you feel ready for more. Be patient. Again, the goal is to enjoy each other.
Renewed Intimacy: Taking the next step
When you and your partner are ready to take your intimacy to the next level, it helps to have a plan. Waiting for a passionate moment sounds nice, but that happens more in movies than in real life. There’s nothing wrong with a little romantic strategy!
- Set a time. Scheduling a time to be intimate shows that you are making it a priority in your relationship. Having a set time can also help build anticipation.
- Throw out the playbook. Keep an open mind. There are many ways to give a partner sexual pleasure besides traditional intercourse. Be guided by what feels good rather than by what you think you should be doing.
- Speak up. Not even the best of partners can read your mind. Gentle, encouraging instructions can do a lot to give your partner confidence and increase your own pleasure. And if you need your partner to take the lead, say so.
- Switch it up. Positions where one partner puts a lot of bodyweight on the other may not be comfortable. Try side-by-side positions where your bodyweight is supported. You can also look up ideas together to spark inspiration and excitement. Not comfortable looking up those topics? The American Cancer Society has some great ideas for positions that may be comfortable and pleasurable for both parties.
- Have the right tools. You may experience vaginal dryness or irritation as a result of cancer treatment, age, or nervousness. Try a water-based lubricant to ease friction. A handheld vibrator can provide stimulation without penetration, and using tools and toys that you both are comfortable with can add another exciting element. Practicing Kegel exercises can help you learn to relax the vaginal muscles, and deep breathing can help as well.
- Let your mind lead. Our mental and physical states are closely linked, and it may be helpful to think about something you find stimulating. Romance novels or romantic movies before intimacy may help both you and your partner.
- Ask for what you need. This is just great advice for intimacy no matter what. Remember, even though it may take more work to get to a point where you feel stimulated, you are worth it! Know that by getting what you need to enjoy yourself, you are doing both parties a favor.
When To Seek More Help
Your cancer specialist or gynecologist is a great resource for discussing genital pain or pain during intercourse. No one can help you if they don’t know what’s wrong! Break the cycle of silence by being an advocate for yourself. Some cancer centers may have sexual rehabilitation resources, so be sure to ask about all the available offerings at your treatment center.
Note that the term “sex therapist” is not regulated, so if you look into sex therapy sessions, be sure you feel comfortable with the therapist’s qualifications. The American Association of Sexuality Educators, Counselors and Therapists is a good place to start.
Keep in mind that a general therapist or counselor can talk to you about sexual concerns and should be able to provide additional resources. As you navigate your new post-treatment life, it’s never a bad idea to sign up for a few sessions of counseling, with or without your partner, to talk about getting used to your post-cancer adjustments.
And Don’t Forget…
There is no secret formula that works for every couple. Some couples find that they are quite happy having very little or no sexual contact. Couples may feel pressured to mirror their relations around what they think other couples or doing or what they see portrayed in movies. Remember that your relationship doesn’t answer to anyone but you and your partner. Be fiercely committed to open communication, and don’t let pressure from outside sources dictate how you and your partner connect.
Stay happy and healthy, friends!
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.