Cancer and its treatments can cause many changes to the body. One of the most common problems is also the least discussed: the impact on a person’s sexual health. A recent study showed that 87% of cancer survivors experience sexual side effects. But many cancer patients, especially women, are not getting the help they need. The same study showed that doctors are more than twice as likely to ask men than women about their sex lives.
Of course, treating the life-and-death issues of cancer take first priority, but impaired sexual function can have a major impact on someone’s total well-being, leaving them feeling isolated and insecure.
Two Memorial Sloan Kettering experts in sexual health recently offered their advice for patients on Cancer Straight Talk from MSK, a podcast hosted by medical oncologist Diane Reidy-Lagunes. Jeanne Carter, a clinical psychologist and sexual health therapist, and Ashely Arkema, a nurse practitioner who focuses on gynecologic health and sexual dysfunction, discussed how — and why — patients should speak openly with their doctors. The podcast also featured two female cancer patients who spoke about the challenges of resuming sexual activity during and after treatment.
“When I see patients, I encourage them to advocate for themselves and try to ask for services,” Ms. Arkema says. “I think the important thing is to know that these are really common issues and you’re definitely not alone if you’re feeling this way.”
Dr. Carter and Ms. Arkema both stressed it’s also important for medical staff to be proactive about asking patients about their sexual health. Patients need to know that MSK offers a variety of ways to help women and men manage sexual health concerns.
Many women say there are physical changes that make sexual activity difficult. For example, chemotherapy and radiation can cause dryness to the vulva and vagina, which makes conventional intercourse difficult or painful. This problem can be especially acute when treatment triggers early menopause. Fortunately, many vaginal moisturizers are available that can alleviate this condition.
Dr. Carter says women with cancer may need even more moisturizing than they expect to maintain comfort. The product instructions may recommend using it once or twice a week, and only in the vagina. But a clinical trial showed that women with cancer need moisturization three to five times per week and need to apply it both internally (in the vagina) and externally (on the folds of the vulva).
One patient who shared her experience, Mackenzie Dougherty, said it was a relief to be honest with both her doctors and her husband about how treatment was affecting her. After a double mastectomy, she says she lost feeling in her breasts and experienced vaginal dryness from the chemotherapy. Letting her husband and doctors know how she felt helped improve both issues. She learned which products would work best for her, and her husband understood how she was feeling.
“It helps having a partner who reminds you every day that you are beautiful in this new form — that you are beautiful with no hair, and you’re beautiful with hair,” she says.
Letting Go of Old Habits
It’s also important for patients to avoid putting pressure on themselves to get “in the mood” and try to force intimacy, MSK experts say. Libido can be tricky, and if someone is thinking too much in the moment, arousal tends to decrease.
“If the old sexual repertoire is not working as well, it may be good to add things in to make it more creative and fun and spontaneous,” Dr. Carter says. “I think the mind-body connection is completely enmeshed in sexuality. Also, a lot of times if people are on treatment and they don’t have energy, they don’t necessarily have to be sexual, but they can be intimate and enjoy the hugging and touching and kissing and caressing and feel like a sexual being.”
- Cancer and its treatment can affect a person’s sex life.
- Fatigue and discomfort with sexual activity are common side effects.
- MSK has support services and specialists who can help with many sex-related issues.