Having cancer doesn’t mean you are no longer a sexual person. However, treatment such as surgery, chemotherapy and radiotherapy can affect your sexuality. This includes your interest in sex, your ability to give or receive sexual pleasure, how you see yourself and how you think others see you. Some of these effects are temporary while others are permanent. All can be managed or controlled.
As individuals, people not only have different ways of expressing and defining sexuality and intimacy, but they also place their own importance on these needs.
Some people may feel an increased need for sexual and intimate contact for reassurance. Some may be less interested in intimacy and sex, or feel that these things are temporarily less important. Others may feel too tired or sick to want sex, or feel they are less sexually attractive to their partner because of changes that cancer and its treatment have caused to their body.
If you are concerned about changes to your sex life, it is important to talk to your partner. He or she may feel that, if they raise the topic, they might place too great a demand on you or might make you feel guilty.
You can also talk to your health care team about the potential challenges you may face having cervical cancer. Knowing what changes may occur, and addressing them if they affect you personally, will help you overcome or adjust to the changes.
Effects on your sex life
You don’t need your cervix to have sex but treatment for cervical cancer can affect your sex life. Many of these effects can be prevented or treated.
- Lack of interest or loss of desire for sex: Low libido is common during cancer treatment. Sometimes it can be brought on by anxiety and worry about your diagnosis rather than the treatment. Libido usually returns after treatment is over.
- Temporary pain: After a hysterectomy you will have to wait several weeks before having sex again. In the meantime, kissing, caressing and touching can also be pleasurable.
- Vaginal dryness: The main effect of treatment will be on your vagina. If the ovaries have been affected by surgery or radiotherapy the production of oestrogen will drop or stop. The loss of oestrogen may make your vagina dry and it may not expand as easily during sexual intercourse.
- Vaginal shortening: After a hysterectomy, the top part of the vagina is stitched up. This shortens the vagina. If you receive radiotherapy, it can also cause the vagina to become tender, shorten and narrow. The length of your vagina doesn’t affect your ability to feel sexual pleasure and you don’t need the uterus to have an orgasm. However, vaginal tenderness may make intercourse uncomfortable, and you may notice some difference because the muscles that normally contract during an orgasm have been removed. The clitoris and the lining of the vagina remain sensitive.
- If fatigue is a problem, try different times of the day to be intimate.
- If you are experiencing low libido, talk to your partner about how you are feeling. They need to know when you feel ready for sex and ways to help you get in the mood.
- Although sexual intercourse may not always be possible, closeness and sharing are vital to a healthy relationship. Explore other ways of sharing intimacy and showing affection for each other such as touching, holding, hugging and massaging.
- Stimulate and help your partner reach orgasm.
- Use a dilator, which is a tube-shaped device made of plastic or rubber, to keep the vagina open. A dilator is different from a vibrator. A dilator is used to maintain the shape of your vagina, while a vibrator is used to give sexual pleasure. Your health care team can show you how to use a dilator. If you are ready and able, have regular gentle sex to help widen the vagina.
- Apply a water-based vaginal lubricant to relieve dryness or painful irritation. Avoid Vaseline or other oil-based lubricants as they may cause irritation.
- Take more time over foreplay to help the vagina relax and become well lubricated. This will make penetration or intercourse less painful.
- Ask your doctor about hormone replacement therapy (HRT).
- Try different sexual positions if your usual ones are uncomfortable. Use cushions or pillows to support your weight.
- Suggest a quick lovemaking session rather than a long session.
- If you have a stoma, the Cancer Council NSW booklet Sexuality for People with a Stoma has more information. For a copy call the Cancer Council Helpline on 13 11 20.
Regaining sexual confidence
For most women sex is more than arousal, intercourse and orgasms. It involves feelings about intimacy and acceptance, as well as being able to give and receive love.
If we are not comfortable with the way we feel about our bodies, this may affect our confidence and desire for sex.
Some women worry about being rejected by their partner, or any new partner, because of changes to their body, whether these changes are visible or not.
It is sometimes difficult to communicate sexual needs, fears or worries with your partner in an intimate relationship. After treatment to the vulva, you may find it even more difficult, but you may be surprised and encouraged by the amount of tolerance, trust, tenderness and love that exists between you.
However, problems can arise because of misunderstandings, differing expectations, and different ways of adapting to changes to your sex life. If this happens, you may find counselling helpful, either with your partner or on your own. You may be able to work through these challenges towards a new closeness and understanding.