Healthy sexuality for people with cancer
Nearly all of the sexual problems people have with cancers are variable and can be temporary. Loss of control, loss of part of your body, grieving and anger; all of these can be healed, or resolved to an extent, given the opportunity and time. Support from people around you can be very helpful. Cancer need not mean the end of your sexual life, whether you are heterosexual, gay, bisexual, transgender, and in a relationship or not.
Communication and information
Communication is essential for healthy sexuality in a relationship. You can use this section to find out more about possible side effects, so that you can prepare yourself for changes. You and your partner, if you have one, can consider how to manage this aspect of your life. You might want to gather more information or resources to help you feel in control of maintaining good sexual self-esteem while having treatment.
Changes
Being open to change encourages healthy sexuality. You may need to develop a whole new style of openness and flexibility in your relationship.
It might be, for example, that one of you has always taken the lead in sex. This may have to change now. It could be that your favourite lovemaking positions are no longer comfortable, if only for a time. One or both of you may have seen sex as being entirely about intercourse. Clearly if penetrative sex is impossible for some reason you may want to start exploring other ways to have sexual pleasure.
Acknowledging needs
Acknowledging your own and your partner’s needs is essential for healthy sexuality within couples. Remember that it’s not just the person with the cancer who will be affected. It can be more upsetting to watch someone we care for undergoing surgery and other treatments than to go through it all ourselves.
Partners
Sometimes it is the partner of the person with cancer who has a problem about sex.
Your partner may feel afraid to touch you for fear of hurting you. Some people incorrectly believe they might catch the cancer through sexual contact. Your partner may lose desire as a direct result of the changes brought about in you. They may also feel rejected if they do not realise that your lower sexual desire is due to the cancer or its emotional effects.
Changed sex drive
It is also important to acknowledge that your partner’s sexual drive may not be reduced. Sometimes it can even increase, if intimate touch helps to reassure them in times of stress. It may be important to talk through with your partner how they might increase their own self-stimulation to reduce any frustration resulting from reduced sexual contact. This may not be what you would ideally want but it can be a useful way for both of you to meet your needs.
Emotional intimacy may increase through greater communication, even when sexual intercourse is not possible.
Books and videos on sexual issues are available from shops and the internet - often they are not on display in shops so you may need to ask directly. Your local library may also have some useful books that you can borrow.
Starting again
Starting again and relearning about sensual bodily pleasures may be important for anyone who has a break in sexual contact. When rebuilding intimacy you may need to start very slowly and gently. Try caressing one another without a goal of orgasm or penetration. Remember that there are many loving and erotic activities other than intercourse.
Early on, and perhaps even while your therapy is going on, you can keep love alive by cuddling and holding one another. Learning to massage one another can be supportive.
A person with cancer doesn’t have to give up sexual contact completely.
Some people may find that they do not miss sexual contact and that not having sex is not a problem for them.
A healthy sexual self-esteem is about being true to ourselves. We are free to make choices about how we express our feelings, and to decide which sexual behaviour suits us and how, or if, we then share ourselves with others.
Possible changes
One thing is certain, when you have been through the diagnosis of cancer you’ll never be the same again. Your view of your life, your relationships, your job and your family will all change. Managing all this change can be difficult to deal with, but you can use this challenge to build your relationships.
Many people report:
- becoming more honest with their partner
- stopping putting off things that they want to do sexually or otherwise
- starting to be more realistic about life in general
- taking up new interests that they’d been putting off for years.
Professional help
The idea of getting back to normal may well mean a whole rethink of your sexual life. This might not be easy. If you find that things aren’t going well, look for help sooner rather than later.
If you have had problems for a while, remember that sex therapists and counsellors are used to helping couples who have let matters drift, slowly getting worse, so that by the time they get help the relationship may have serious problems.
A good place to start is at your GP. There might be a counsellor in the practice. If not, they will definitely know how you can contact one. There are some useful organisations listed in our database.
Common questions about sexuality and cancer
Can I catch cancer from my partner?
No. If your partner has a cancer, you can’t catch it from any sexual activity. You can’t catch cancer by having sex.
Could sex make my cancer worse?
No. In fact, sex and all the love and caring that goes with it can be helpful to people who have cancer. Many people feel depressed, unlovable, guilty or afraid when they have cancer or are having treatment. Their partner’s affection and acceptance can make a big difference. Sex does not make the cancer more likely to come back or spread.
Can chemotherapy drugs be present in sexual fluids?
It is not known whether chemotherapy drugs can be present in semen or vaginal fluids. It is safest either to avoid sex or to be sure to wear a condom, or use some other form of barrier contraception, during and for up to a month after chemotherapy. Using barrier contraception removes any potential risks and avoids the stinging sensation that some partners report.
When can I become pregnant?
For women who can still have children it is essential to avoid becoming pregnant during treatment with chemotherapy. This reduces the risk of damage to the baby should any of the chemicals be absorbed. Many doctors recommend not becoming pregnant or fathering a child for up to a year after treatment, as this is the time when the cancer is most likely to come back.
How soon can I have sex after treatment?
Vaginal intercourse is probably best avoided very soon after pelvic surgery in women. The time to get back to sex will vary greatly according to the sort of operation you had and how quickly you are healing. Some types of cancer (of the cervix or bladder, for example) cause bleeding from the vagina or in the urine. If this sort of bleeding is made worse by intercourse then it is sensible to stop until treatment has stopped the bleeding.
Are there any good positions for making love after cancer?
This will depend a lot on which part of the body is affected by the disease. If it is the pelvic area then it will take some gentle and patient experimenting to discover which lovemaking positions now suit you both. This can also be true after a mastectomy when some people say that they don’t want their lover’s weight resting on them.
Making love side by side, or swapping who’s on top, may be better. Most couples find that with loving communication they can sort out what suits them best. The things you find most enjoyable will change with time, so be prepared to change what you do.
How can I overcome problems of tiredness?
Be flexible about the time of day you make love. Experiment with less demanding positions for lovemaking. You can agree with your partner that lovemaking need not always mean a long session.
I am embarrassed about my scars but still want to make love
It is a good idea to first talk things through with your partner. Most people find their lovers are much less concerned by their scars than they imagine, and once the subject has been discussed openly they can feel more relaxed about the changes in their bodies.
Why not try making love in the semi-darkness to avoid being seen so clearly? Some women also say that they find having sex with their bra on after a mastectomy makes them feel sexier. This both holds the false breast (prosthesis), if there is one, and helps to hide scars. Crop tops or an all-in-one with gusset poppers can be comfortable without you having to be completely hidden. Men may also find it helpful to wear clothing during sex if they are bothered by their scars.
