Now that cancer treatment is over, some adjustments will need to be made moving forward. This may include going back to work, reminding yourself that you can return to old activities, and even accepting the fact that you’re no longer “sick.” Another issue that most cancer survivors need to face is sexual intimacy. In fact, nearly 60% of cancer survivors report experiencing sexual dysfunction after treatment according to one poll conducted by LIVESTRONG. Additionally, long-term concerns regarding physical intimacy were reported among as many as 85% to 90% of prostate, breast, and gynecologic cancer survivors.

Common Emotional Concerns Regarding Sex after Cancer

Sexual concerns after cancer can be both mental and physical in nature. Emotionally, both partners may feel nervous about having sex after one of them has had a serious illness. A survivor’s partner may be concerned that they are pressuring or causing physical pain to his or her partner. A survivor may be worried that his or her partner will have a negative response to the look of their body if it has been changed by cancer. These “body image issues” involve your mind (how you now feel about your body) and your body (your new physical appearance).  

Both partners also may be curious about whether they’ll be able to achieve orgasm due to a lowered sex drive. It may also take time to adjust back into a romantic partner relationship now that the patient/caregiver relationship that may have existed during treatment is no longer necessary. 

Physical Symptoms of Sexual Dysfunction

While not all cancers and their treatments are associated with specific symptoms of sexual dysfunction, some do. The following symptoms do not affect all survivors but are considered relatively common. The good news is that many of these symptoms will eventually go away.

Breast Cancer

• Loss of sensation, fatigue, and symptoms related to reconstructive surgery (such as feeling discomfort while getting used to implants) may be experienced by those who had a mastectomy (removal of one or both breasts)
• Patients who undergo a lumpectomy may experience decreased sensation in their breasts and nipples, and lymphedema
• Breast cancer patients who receive chemotherapy, radiation, or hormone therapy could experience menopausal symptoms (mood swings, vaginal dryness, vaginal atrophy, and lowered libido or sex drive), fatigue, increased scarring and lymphedema

Colorectal Cancer

• Bowel/bladder changes and complications associated with ostomies/stoma could be experienced by colorectal patients who receive surgery and/or radiation therapy

Prostate Cancer

• Patients diagnosed with prostate cancer who receive surgery may experience erectile dysfunction (inability to achieve or maintain an erection), difficulty climaxing, dry orgasm, and decreased libido 
• Erectile dysfunction (ED), lowered libido, hot flashes, and gynecomastia (growth of breast tissue) may affect prostate cancer patients who received hormone treatments 

Gynecologic Cancers: Including Ovarian, Cervical, Vulvar Cancers, or Endometrial (Uterine)

• Gynecologic cancer patients who receive chemotherapy or radiation may experience low libido, menopausal symptoms, fatigue, increased scarring, bowel and bladder issues
• Having a hysterectomy could result in loss of sensation, menopausal symptoms, fatigue, lymphedema in lower extremities, and/or prolapse (when the uterus, bladder, vagina, or surrounding structures begin to fall out of their normal positions)

Communication is Key

The key to a healthy and fulfilling sex life after cancer is communicating openly and honestly with your partner. Sharing your anxieties and fears with your partner is the first step toward restoring a sex life that satisfies you both. Not only is discussion healthy, it’s the only way to truly resolve issues. And, a lot of times, couples discover that their biggest fears were all in their head. 

Intimacy is a topic that can sometimes be difficult to talk about. In cases such as this, individual and/or couples counseling can be very helpful. If you’re experiencing anxiety surrounding your sex life, take time to have an open and honest conversation with your oncology team or another healthcare provider. They will most likely be able to recommend therapists, and tools and techniques to improve your libido and sexual function.

Strategies for Improving Sexual Desire and Function

It’s important to remember that physical symptoms, emotions, and relationships look different among cancer patients. There is no one-size-fits-all regimen for getting your sex life back on track after cancer. With that said, there are some suggestions to consider:

• Make sure you are getting good and enough sleep
• Try to improve your self-acceptance and self-confidence (your partner found you attractive before cancer and may find you even more attractive as a survivor)
• Work on relaxing
• Make time for regular exercise (get the OK from your doctor)
• Talk to your doctor about side effects your medications may be causing (and about re-evaluating medications if needed)
• Use lubricants during intercourse for short-term relief from vaginal dryness
• Use vaginal moisturizers daily for long-term relief from vaginal dryness
• Ask your doctor about estrogen as a possible remedy for vaginal symptoms
• Consider therapy or medication if you have anxiety/depression
• Experiment with different sexual positions and/or sexual aids
• Practice pelvic floor (Kegel) exercises to strengthen pelvic muscles

Remember, adjusting to life after cancer takes time. You and your partner have been through ups and downs during your cancer journey— but you’ve made it through! Do all you can to enjoy life and rediscover the things you pumped the brakes on during cancer treatment, including intimacy. Be patient and empathic to each other and if needed, consider getting professional help. There are many important components of your overall health and quality of life as a cancer survivor and your sexual health is one of them!