From MayoClinic.com
Special to CNN.com
Whether it’s cuddling, kissing or sex, intimacy with a loving partner can help you feel better about yourself as you go through cancer treatment. During and after your treatment, you may find that your libido has changed. Loss of libido is the most common problem affecting cancer survivors looking to continue or resume sexual intimacy.
Losing interest in sexual activity can create tension between you and your partner, adding to the stress of treatment. Identifying the causes of your disinterest is the first step toward finding a solution. Open communication with your partner and your doctor can help you regain your libido or help you redefine what it means to be intimate.
Physical changes that can cause loss of libido
Loss of libido may be caused by physical changes to your body as a result of cancer treatment. For instance, women may experience symptoms of early menopause, such as vaginal dryness, and men may experience erectile dysfunction. Discuss these changes with your doctor.
Feelings that can cause loss of libido
Cancer is a physical disease, but going through a cancer diagnosis and treatment can be very emotional. You may worry about your future, stress over your treatment decisions and find joy in the small triumphs in overcoming your cancer. All of these emotions influence how you feel about yourself and your attitude toward intimacy. Some common feelings that can negatively affect your libido include:
Guilt
You may feel guilty because you feel previous sexual experiences caused your cancer. Cancer can’t be transmitted sexually. Although some cancers are more likely in people who have human papillomavirus (HPV), which is transmitted sexually, many people live with HPV and never develop cancer. Other sexually transmitted viruses that put you at risk of cancer include hepatitis C, HIV and Epstein-Barr virus.
Fear
You may fear that sexual activity can cause a recurrence of your cancer or that you will pass your cancer on to your partner. Sexual activity has no influence on whether you’ll experience a cancer recurrence. Your doctor can discuss your prognosis and chances for a cancer-free life. You can’t pass your cancer on to another person.
Depression
Sadness or feelings of worthlessness are common signs of depression, which causes a loss of libido and decreases the pleasure you experience during sex. People with cancer are more likely than others to experience depression. Depression is treatable, so talk to your doctor about your feelings.
Self-consciousness
Changes to your appearance after cancer treatment can make you feel self-conscious. For instance, the loss of your hair from chemotherapy, the loss of a limb, breast, or testicle, scars from surgery, and ostomies can make you feel less attractive. Many people find that their partners aren’t as concerned about these changes as they are. Still, it takes time to become comfortable with the changes in your appearance. Your doctor may have suggestions to help you regain your self-confidence. Talk with other cancer survivors for ideas on ways to make you feel more sexually attractive.
Grief and loss
Feelings of grief and loss can result if you feel cancer treatment has significantly changed your body. Some people might say they feel less feminine or masculine. For instance, a woman who has a hysterectomy may feel a sense of loss and perceive herself as less of a woman. A man may feel he’s less of a man if he has his testicles removed (orchiectomy). For some people, treatments alter how they view themselves and make them very dissatisfied with their bodies. Although some sense of grief and loss is expected with the physical changes, you can and should feel satisfied with your body and feel positive about yourself. Talk to your doctor about how you feel. Ask him or her for a referral to a clinical health psychologist if you have strong feelings of dissatisfaction with yourself and your body.
Stress
Being diagnosed with cancer and beginning your treatment is stressful. This makes it difficult to get into an intimate mood because your mind is distracted. If you’re in a relationship, stress can exacerbate any pre-existing problems you may have had. Talk with your partner about how you feel.
Anxiety
The thought of resuming sex after your cancer can cause anxiety. You might be unsure of how you’ll perform. If you have a partner, you might find yourself avoiding all intimacy. If you’re single, you might be hesitant to date because you aren’t sure how or when you’ll reveal your cancer experience to a new partner. Anxiety is common, and it may help to talk through your feelings with your partner, your doctor or a clinical health psychologist.
Consider your partner’s feelings toward sex
Many times, cancer survivors say their partners go through cancer with them — standing by them and supporting them from the first diagnosis through the uncertainty of life after treatment. It’s an emotional time for your partner, too, and sometimes partners feel afraid or reluctant to resume sex. Your partner may be afraid that he or she will hurt you or that you’ll interpret his or her advances as pressure to have sex. Your partner’s role as caregiver during your treatment can make him or her see you as a vulnerable patient, rather than the partner you think of yourself as.
In many cases, communication about how both of you feel can make situations like these easier. But many couples didn’t spend much time discussing sex before, and adding cancer to the mix makes it all the more difficult. Couples therapy may help you open the lines of communication and better understand your situation.
What you can do to regain your libido
If you’ve experienced a loss of libido, you may feel alone. You might not want to talk about your feelings, but you should. The problem won’t resolve on its own. It will take cooperation between you, your partner and your health care team to ensure that you feel comfortable resuming sexual activity. Consider trying to:
- Talk with your doctor or nurse. If your doctor hasn’t discussed sexuality, take the lead. Your doctor or nurse can help you find resources and refer you to a clinical health psychologist.
- Talk with your partner. One of the best ways to improve libido is to open the lines of communication between you and your partner. For instance, your partner may fear hurting you during sex and may avoid initiating sexual activity. You may believe your partner is no longer interested in you. A conversation about the issue can clear the air and restore emotional and physical intimacy.
- Talk with other cancer survivors. People who have had your same cancer and have endured your same treatment are likely experiencing the same loss of libido. Look for other cancer survivors in support groups in your area, or you may be more comfortable connecting with other survivors on Internet message boards. Contact the American Cancer Society for information.
- Change your definition of sexual intimacy. Maybe you aren’t ready for sex. Talk about this with your partner and look for other ways you can be intimate. Simply spending quality time together may help you reconnect and slowly move toward resuming sexual intimacy.
- Track your desire. You might think you’ve lost all interest in sex, but you may have sexual thoughts throughout your day that you ignore. Make a note of times during the day when you think about sex. If you find certain times of the day or certain situations rouse your interest in sex, use those cues to help put you in the mood.
Loss of libido is common after cancer treatment, but that doesn’t mean you can’t regain the sexual intimacy you once enjoyed. Broaching the subject with your doctor, partner or even members of a support group may help you work through your emotions and enable you to resume a satisfying sexual relationship.
