Yes, sexual difficulties can lessen! But before talking about specific methods it is important to recognize some basic ideas about continuing your sexual life during or after cancer treatment.
1. Educate yourself. Talk with your doctor, nurse, etc. to learn about the effects of your cancer or your treatments on sexuality. For example, the American Cancer Society (http://www.cancer.org) has two excellent booklets available for a nominal cost: Sexuality for the Woman with Cancer, Sexuality for the Man with Cancer.
2. Keep in touch. Pleasure from touching is possible regardless of the type of cancer treatment one has had. As has often been said, the most important sexual organ is... the brain!
3. Leave routines behind and move forward. We can all have very narrow views of what is “normal” or what the “typical” sex life should be. Cancer is a life disruptor, but it can also offer new ways to experience life, new ways to give and receive pleasure. Often patients’ greatest need is not for sex (the ‘act’) but physical intimacy, such as being held, holding another, or cuddling. The most important step individuals and couple can make is to preserve personal and physical intimacy (touching) times when routines get disrupted.
4. Talk and share information. Good communication is the key to successful relationships, and good communication is essential to adjusting a sexual routine with a partner.
When addressing sexual problems it is important to first appreciate that sexual problems following cancer are common. In particular, the most frequent symptom is a loss of sexual desire. Fatigue can be a powerful contributor, as it remains a significant problem with full recovery taking upwards of 2 years after all cancer treatments end. As noted above, sexual educational materials can be quite important. For women, managing menopausal symptoms relevant to vaginal health should be done. The most common symptom is vaginal dryness, which is usually accompanied by diminished sensation and pleasure and possibly dyspareunia with partnered activity. Many such problems will be reduced if not eliminated with the regular use vaginal moisturizers, such as Replens® and the use of vaginal lubricants, such as K-Y jelly, during intercourse. For women who talk with their physician and learn that they can receive estrogen replacement therapy (ERT is contraindicated for those with breast or ovarian tumors), vaginal treatments (creams, tablets, estrogen-releasing ring) may be an option.
For men, surgical treatments for prostate or testicular cancer may result in significant problems of erection and/or ejaculation that may be permanent. Hormonal treatment for prostate cancer can reduce sexual desire further and cause menopausal like symptoms (hot flashes, sweats). Nevertheless, treatments are available including medication such as Sidenafil (Viagra), erectile injections with medication such as Papaverine, use of constrictive penile rings or vacuum devices, or penile prosthesis surgery (pump devices). All of these treatments can be enhanced with concurrent sexual therapy.
For those with pervasive sexual difficulties, discussion with a physician — such as a gynecologist for women and a urologist for men — is an important starting point to rule in or out physical sources of sexual dysfunction. There after, seeking counsel from a trained, licensed professional whose specialty is behavioral sex therapy is suggested. When seeking such counsel, ask the therapist the first session (or before hand) how many cancer patients with similar difficulties they have previously treated and with what success.