Intimacy, Sexual Function and Fertility

At times, side effects from cancer treatments and the stress of the cancer experience can lead to sexuality and intimacy issues with a partner or loved one. In addition, some types of cancer treatment can impact your ability to have children. There are specific steps you can take to address both intimacy and fertility concerns. Above all, talk with your doctor or nurse about your concerns—you are not alone with these issues and there is help available.

Sexual Intimacy

When cancer and its treatment interfere with your sexual relationship with your partner, it can create a lot of distress. Despite the many types of cancer and cancer treatments, most sexual problems after cancer may fall into the following categories:
  • Loss of sexual desire in men and women
  • Trouble getting and keeping an erection for men
  • Having pain with genital caressing or vaginal penetration for women

Ten suggestions to regain your desire for sex after cancer:
1. Discuss with your doctor if any of the medications you may be taking could be decreasing your desire for sex. You may be able to try a different version or lower your dose.
2. If exercise and nutrition help you feel less tired and reduce physical pain, it may also give you more energy to be in the mood for sex.
3. If you think that you are depressed, see if short-term counseling can help lighten your mood. People who are depressed often lose interest in sex. Although antidepressants can help your mood, and may be important for more serious depression, they can also interfere with sexual desire and make it hard to reach orgasm (especially for women).
4. If you are feeling unattractive, consider what you can do to feel better about your body and your looks. Pamper yourself with a bubble bath or a massage. Find some sexy lingerie to cover a surgical scar during lovemaking, or wear a nice scent.
5. Many men or women report that they have distracting thoughts about cancer during sex that interfere with being able to relax and enjoy good physical feelings. You can try giving yourself the luxury of just focusing on your own sensations during lovemaking.
6. If you feel comfortable with self-touch or masturbation, take some time to relax in private, perhaps after a bath or shower. It may take some patience and practice to feel sexual pleasure again.
7. If you are a man with an erection problem, see an urologist to explore medical treatment: medications, penile injections, or even surgery to have a penile prosthesis. For men, being able to have firm erections can be the biggest boost to interest in sex.
8. If you are a woman who is having pain during sexual touching or intercourse, it is crucial to get some help. A first step is usually to use a vaginal moisturizer regularly and put lots of thin, water- or silicone-based vaginal lubricant when you have sex. If your pain persists, see your gynecologist for help.
9. If the problem with desire is focused on a loss of attraction between you and your partner, couples or individual counseling can help pinpoint what is going on.
10. Not all doctors have experience with sexual intimacy. You may ask your doctor for a referral to a medical gynecologist with expertise in treating women who have had cancer or a urologist who specializes in helping men with erection problems.

Fertility and Cancer
If you have not started cancer treatment, it is important to talk to your doctor or nurse about any concerns regarding your fertility later on. An open discussion with him or her will help you plan your cancer treatment and know what to expect. Sometimes your oncologist may not be well-informed about fertility problems or may look at this issue as less important compared with saving your life with cancer treatment. But you have a right to get answers to your questions, even if it means asking for a second opinion or seeing a specialist. Talk to an oncologist, surgeon, gynecologist (OB/GYN), nurse, reproductive endocrinologist, or infertility specialist. There are several great resources available that offer information about cancer treatments and the potential fertility risks for men and women. Below is a list of great resources:

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