What is Sexuality?

Sexuality is an important part of our everyday life and also a part of who we are as man, woman and partner. Sexuality is one way to fulfil our needs for closeness, touch, playfulness, caring and pleasure. Feelings about our sexuality provide zest for our life, impact our self-esteem and body image, and affect our relationships with others.

As important as this is for each of us, many patients and their health care providers do not discuss the impact of cancer, its treatment or surgery on sexual health.

What is a normal sex life?

It can be:

• whatever gives the patient and partner pleasure

• touching and other signs of affection that do not necessarily end in intercourse

• an active interest in sex throughout your life, regardless of age

• positioning that takes into account a patient’s physical condition

• A normal sex life can even include a temporary loss of interest in sex when you don’t feel well or are preoccupied with concerns for your health. This is normal!

Returning to sexual activity after surgery

Doctors usually recommend waiting 4-6 weeks after surgery before returning to sexual intercourse. This gives you a chance to regain your strength and stamina. It also gives you and your partner time to share your concerns and feelings and permits the resumption of your relationship in a slow and relaxed manner.

When you feel ready try sexual touching with your partner. Start with plenty of time and privacy to create a relaxed environment. Plan for time when you aren’t too tired and when any pain is well-controlled. Although you may feel a little shy, let your partner know that you would like to have some physical closeness. You could even make a date. You might say, “I feel ready for sex again, but I’d like to take things slowly. Would you be in the mood tonight to try a little touching? I can’t promise that it will go perfectly, but we can have fun trying.”

What causes sexual problems for cancer survivors

• Medication side effects

• Self-esteem issues including altered body image as well as altered roles and relationships

• Physical issues including fatigue, fragility, vaginal dryness, yeast infections, etc.

• Loss of intimacy

• Depression and fear

• Lack of interest

While the issues above may be physical or emotional, they can all lead to a lack of interest in sex. After surgery is complete, or treatment has begun, there may still be little interest in sex. Loss of interest in sex may be due to very real issues including concerns for survival, worry or depression, nausea and vomiting, pain, relationship conflicts or any emotion or thought that keeps you from feeling sexually excited. This may include anxiety that your partner may not like the changes in your body.

Other causes for disruptions in your sexuality may be the underlying disease, medications and physical changes in your body. These can include weight gain or loss, acne, unwanted hair growth or hair loss. For some patients, surgical scars may cause them to feel unattractive, thus decreasing their interest in sex.

For a woman, uncontrolled blood sugars can play havoc with her reproductive, as well as her overall health. High blood sugars can promote yeast infections and vaginal irritation. Low oestrogen levels can also cause lubrication problems.

Many medications affect sexual functioning so it is important to talk with your health care team to obtain a good understanding of your medications and their side effects. The process of dealing with chronic illness and recovery can affect many patients emotionally. Other emotional or psychological factors that can impact sexuality include a sense of losing control of bodily functions, anger, anxiety, disappointment, fear, isolation and sadness.

Remember to communicate your fears, hopes and dreams to your partner and listen to their concerns as well. To nurture your love life, you must keep emotional connection and commitment alive.

Written by Prof Elna McIntosh