Sexual health during and after cancer treatment isn't talked about enough.
Surgery, chemotherapy, radiation or other cancer treatments can impair sexual function, as well as create issues with sexual desire and arousal. Some patients may question whether sexual pleasure is still possible. And there are often emotional challenges as well as physical ones.
"It's our job as health care providers to include sexual health and recovery in our care," says V. Bernadene Stoody, M.D., M.Sc.., an adolescent medicine fellow at Michigan Medicine. "I want patients and caregivers to know that education and resources are available that can empower them to ensure that their needs as a whole person are being met."
Just because you've been diagnosed with cancer doesn't mean your sex life is taken out of the equation, she told an audience of young adult cancer patients and survivors during a recent presentation.
"Good sex is important," she told them.
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If your care team doesn't bring it up, cancer patients and advocates are encouraged to ask their medical team how their treatment may affect their sexual health, and what rehabilitation resources are available — such as meeting with a gynecologist or urologist who specializes in sexual medicine — as well as specialized counselling services.
I want patients and caregivers to know that education and resources are available that can empower them to ensure that their needs as a whole person are being met.V. Bernadene Stoody, M.D., M.Sc.
The impacts of treatment can affect both patients and their partners, adds Daniela Wittmann, Ph.D., M.S.W., a social worker and certified sex therapist at U-M who led a national team in developing an online support program for men recovering from prostate cancer treatment.
"Emotional challenges are just as important to recognize as physical ones," she said. "Working with a trained specialist can be very helpful for individuals and couples navigating these changes, which can come with feelings of loss and grief."
Sometimes progress doesn't come as fast as people would like, Wittmann notes. It can take time to adjust to a new way of experiencing sexual pleasure alone or with a partner. It may mean finding new opportunities to explore intimacy and find pleasure beyond intercourse if treatment has impaired sexual function. Orgasms may take longer to reach, and may require more or different types of stimulation.
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Sex therapists and other professional counselors can provide a uniquely safe and powerful space to explore challenges related to intimacy and pleasure, Stoody adds.
Both experts pointed toward physical therapy as an avenue that may be help with sexual rehabilitation in both male and female patients. Exercises that improve pelvic blood flow can enhance erection, and exercises that help to strengthen the pelvic floor can optimize pleasure and decrease vaginal and pelvic pain.
They also note numerous safe and effective products are also available to enhance sexual function. For men, medications, devices such as vacuum pumps and even implants can assist in achieving and maintaining erections. For women, lubricants and medications can increase sexual pleasure.
Online resources
Information from the American Cancer Society
Sexual recovery after prostate cancer online support program