Tips for maintaining sexual health during cancer survivorship

Over half of the people diagnosed with gynecologic or breast cancer report some type of sexual health issue. However, many of these problems can be overcome if you and your partner proceed with understanding, flexibility, and hopefulness.

UAB Medicine’s Sexual Health and Cancer Clinic was created to help patients maintain sexual connection and well-being. The clinic serves patients with breast and gynecologic cancers, those who’ve undergone treatment to help prevent cancer, and those who have specific gene abnormalities that could lead to cancer.

No matter how you feel right now, physical intimacy can always be part of life. The sexual issues treated by the clinic include:

• Low levels of desire and arousal
• Low energy and reduced mobility
• Pelvic pain
• Being unable to achieve orgasm
• Negative body image and low self-confidence

Treatment plans may include physical therapy, counseling, medication, and medical devices and training, as well as education, planning, and support.

Sexual Health and Cancer Clinic Director Christina Wilson, Ph.D., CRNP, shares the following tips for maintaining sexual health during cancer survivorship:

Anticipate predictable changes

Like other important aspects of your life, sexual health may need attention and require you to make adjustments throughout survivorship. If you anticipate common issues and watch for changes, meaningful physical intimacy is more likely. Your life doesn’t have to stop for cancer.

Gynecologic and breast cancers and their treatments may affect women’s hormones, physical appearance, sensation, and mood in the following ways:

• Radiation treatment may cause skin changes.
• Anti-estrogen medications may change patterns of arousal and desire.
• Surgery can impact how you feel about your body and your body feels to you.
• Chemotherapy can cause fatigue, general discomfort, and disinterest in intimacy.

Monitor vaginal health

Vaginal health issues can occur because of cancer itself, immune responses, hormonal changes, and stress. Vaginal dryness is probably the most common issue patients experience that leads to daily discomfort, but it is easily solved. I recommend over-the-counter vaginal moisturizers for everyday use and lubricants for sexual activity. I suggest that patients keep both products in their cabinets now instead of waiting until they are needed. Let your partner know if you plan to start using a lubricant.

Communicate

The desire for sex is complicated, and medications may change your level of sexual interest. Talk to your partner about how you are feeling and how you can change your habits of intimacy together. More consistent affection – such as hugging, kissing, and cuddling – can help. This kind of touch can cause your brain to release chemicals that may put you in a romantic mood. Practicing various forms of intimacy through closeness and conversation may help you maintain your bond with your partner – even if sex itself is less frequent.

Identify other symptoms

Almost anything in life can impact your sexual health. Generic symptoms throughout your body could make you feel less inclined to have sex or cause pelvic discomfort. The symptoms below are closely connected to sexual health, so try to find ways to reduced their impact:

• Fatigue: Chemotherapy and other medications can cause extreme fatigue and can interrupt your life patterns. Exercising is a great way to counter fatigue, so move around and get some steps in.
• Headaches: Headaches can easily interfere with intimacy. If your headaches are persistent or seem to be getting more frequent or intense, ask your provider about prescription medications that may help.
• Mood changes/confidence issues: Desire and sex are psychological as much as physical, and how you feel about yourself can affect how you feel about intimacy. A trained counselor can help you work through common self-image issues, depression, anxiety, and grief that impact sexual health.

Be patient and flexible

Schedule sex if there’s a time you feel your best. Plan relaxing and/or romantic times where you can maintain closeness and intimacy, and don’t worry if the frequency of sex varies.

During cancer survivorship, good sexual health can help you feel like your whole self again. To make an appointment with the UAB Sexual Health and Cancer Clinic, please call 205-996-4662.