Right now, sex may be the last thing on your mind. After all, you’ve been focused on your survival. It is entirely normal to temporarily lose interest in sex and intimacy during and even after treatment. But having a sexual relationship and the intimacy that goes along with it contribute to our zest for living and remind us that we are truly alive. For that reason, it’s important to address and understand any fears or other impediments to resuming such a relationship.

This article touches on one of the many sexuality issues that are common to both men and women who have had cancer. But, as we all know, men and women are different. So, we have two expanded versions of this article on our Web site – one for men and one for women.

Sex Defined

Unfortunately, most of us define sex with one word: intercourse. This is a myth. In truth, sex is any kind of physical expression of intimacy – including kissing and simple, sexual touching. Sex is one manifestation of our need for closeness, caring, and pleasure. Even when sex becomes difficult, such as during a severe or terminal illness, this kind of physical expression remains important to our lives.

Points to Keep in Mind

• No matter what kind of cancer treatment you have had, the ability to feel pleasure from touching almost always remains. Few cancer treatments damage the nerves and muscles involved in feeling pleasure from touch or in reaching orgasm. Sexual touching is often a satisfying experience that produces orgasms. Pleasure and satisfaction are possible, even if some aspects of sexuality have changed.
• Keep an open mind about ways to feel sexual pleasure. Some couples have a narrow definition of what is “normal” in sex. For people who have been in treatment for cancer there may be times when intercourse is not possible. Those times can be chances to learn new ways to give and receive sexual pleasure. At times, just cuddling can be pleasurable.

Coping with Changes in Appearance

This is usually the area that most impedes a person’s resumption of intimate relations. If cancer treatment has left visible changes, someone may feel unattractive and assume that others will thus find him or her undesirable. This usually is not the case. Even in the best of times, we are all more critical of ourselves than others are. That’s why it’s important to first address our own feelings about ourselves, taking stock of our good points and working to dispel negative thoughts.

Taking Stock

What do you see when you look at yourself in the mirror? Many people notice only what they dislike about their looks, such as pale skin, hair loss, an ostomy appliance, or skinny legs. They fail to see their attractive features. The following mirror exercises can help you adjust to body changes:

• Find a time when you have privacy for at least 15 minutes. Be sure to take enough time to really think about your appearance. Study yourself for that whole time, using the largest mirror you have. What parts of your body do you look at most? What do you avoid seeing? Can you catch yourself having negative thoughts about the way you look? What are your best features? Has cancer or its treatment changed the way you look?
• First, try the mirror exercise when fully dressed, as you would be when going out. If you normally wear clothing or accessories to disguise changes from cancer therapy, wear them during the mirror exercise. Now look in the mirror and find at least three positive things about the way you look.
• When you are comfortable seeing yourself as a stranger might see you, try the mirror exercise when dressed as you would like to look for a lover. If you’ve had an ostomy, for example, wear a bathrobe you like. Look at yourself for a few minutes, repeating the steps in the first mirror exercise. What is most attractive and sexy about you? Pay yourself at least three compliments on how you look.
• Finally, try the mirror exercise in the nude, without disguising any changes made by the cancer. If you have trouble looking at a scar, bare scalp, or an ostomy, take enough time to get used to the area. Most changes are not nearly as ugly as they seem at first. If you feel tense while looking at yourself, take a deep breath and try to let all your muscles relax as you exhale. Don’t stop the exercise until you have found three positive features or at least remember the three compliments you paid yourself before.

The mirror exercise may also help you feel more relaxed when your lover looks at you. Ask your lover to tell you some of the things that are enjoyable about the way you look or feel to the touch. Explain that these positive views will help you feel better about yourself. Then, remember them when you are feeling unsure.

Changing Negative Thoughts

Try to change negative thoughts. Remember, a lot of the sexual experience is in your head. Your thoughts can make a sexual experience good or bad. Become more aware of what you tell yourself about how sexy you are. You may be setting yourself up for failure with thoughts like, “How could someone want a woman with one leg?” Or, “How could any woman want a man without testicles?” Almost all of us have put ourselves down as lovers now and then.  

• Write down the three negative thoughts you have most often about yourself as a lover. Some may be connected to your cancer treatment, but other thoughts may have started years ago.
• Now write down a positive thought to counter each negative thought. For example, if you said, “No one wants a lover with an ugly urinary ostomy,” you could say to yourself if you’re a woman, “I can wear a lacy ostomy cover during sex.” Or, if you’re a man, you could say, “I’ll just wear a nice white T-shirt during sex.” The next time you are in a sexual situation, use your positive thoughts to override the negative ones you usually have.

Boosting Self-Esteem

Regularly remind yourself about your good qualities. If you have a favorite feature, one you know people have always admired, indulge yourself a little and play it up. Eat well and exercise to keep your body strong and your spirits up. Practice relaxation techniques to ward off anxiety and depression. 

Communicating With Your Partner

This may be the most important part of resuming sexual activity with your partner. Many people react to cancer by withdrawing. They fear their partners would feel burdened by the sharing of fear or sadness. Or they fear their partners might view them as weak. Sometimes men are the ones who have trouble sharing feelings, but women do, too. Unfortunately, the result is that each partner is left alone to cope with his or her own feelings. No couple gets through cancer diagnosis and treatment without some anxiety, so why not discuss those fears and concerns with one another so that you shoulder the load together rather than alone?

Here are two appearance-related pages that may be of help to women:

• Look Good…Feel Better^®: Click here.
• “tlc” Tender Loving Care™: Click here.