After surviving cervical cancer, I’m teaching my kids about sexual health to save their lives

Using the anatomical names for private parts and getting vaccinations against HPV by age 12 can help keep children healthy into adulthood

Experiences and lessons from childhood can influence a person’s understanding of their own sexual health, and affect the quality of care they receive.

By Eve McDavid

Staring at the speckled gray tiles of the examroom ceiling, I planned out my last day at Google before maternity leave while my OB/GYN performed a pelvic exam. Once we wrapped, I’d zip to the office to tie up loose ends. Instead, I heard her say “irregular” as she discovered a tumor, and my world collapsed.

There are an estimated 36,000 cases of cancer related to the human papillomavirus (HPV) in the United States annually; last year, my Stage 2B cervical cancer diagnosis was one of them. Miraculously, my son arrived safely five weeks early, and I responded incredibly well to treatment. In time, our young family rebounded; I proudly reached remission this year.

As a systems expert who studies patterns in consumer behavior, I felt compelled to understand why so many women are underinformed when it comes to the importance of cervical health care. What I found is that experiences and lessons from childhood can influence a person’s understanding of their own sexual health, and affect the quality of care they receive.

So, how do we help our children — boys, girls and gender non-conforming — become comfortable with their bodies, speak up when issues arise and understand the importance of preventive care? I spoke with public health and medical experts to identify foundational childhood experiences that can normalize sexual health and, most importantly, keep our kids healthy.

Teach the names of private parts

It’s hard for a person to be proactive about sexual health when they’re not comfortable using proper anatomical names for genitals. “Private parts” was the only acceptable term in my upbringing; it was a conscious, necessary adjustment to teach my children to call and recognize their genitals by “vagina” and “penis.” Even if it feels awkward at the beginning, keep going. A 1992 study in the Journal of Sex Education and Therapy found that children whose parents taught them the anatomical names, because of the modeling at home, were most likely to remember.

Children unashamed of their genitals are also more likely to speak up if they’ve experienced sexual abuse or another health issue, says Princess Nothemba Simelela, who leads the World Health Organization’s Cervical Cancer Elimination Initiative.

Simelela says that by age 5, children can understand their bodies and associated boundaries. Using stories and animated graphics, she has taught young girls about what kind of touches are not okay. The same lesson can be taught to boys, too, she says: “You know, if you touch here and here, it’s inappropriate … If somebody fondles you or touches this part of your body, you must let someone else know.”

Get your children vaccinated against HPV by age 12

The Centers for Disease Control and Prevention says the HPV vaccine is the best protection against six cancers caused by the virus and recommends that all children ages 11 to 12 get vaccinated (though kids as young as 9 can receive a shot). A recent U.K. study found that vaccinating girls ages 12 through 18 against HPV could substantially reduce the incidence of cervical cancer, particularly when vaccination happened at age 12 or 13. Education about this issue is particularly important in Black and Hispanic communities, where cervical and other HPV-related cancers are more prevalent.

I received the HPV vaccine in my 20s after I’d contracted a high-risk strain, so it wasn’t as effective; I’m practically counting the days until my children are 9 and I can provide them with the gift of cancer prevention.

“That we have this vaccine that can prevent the virus, it’s kind of a magic bullet,” says Jessica Rose, an OB/GYN at Bellevue Hospital in New York and assistant professor in the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine. “There’s nothing else out there that can do it.”

Twenty years of evidence supports the HPV vaccine, says Maria Trent, chief of adolescent and young adult medicine at Johns Hopkins University.

“The first thing is that the vaccine is safe. It’s been tested on millions of people, and the thing is that we’ve seen change, just like we’ve seen change with the chickenpox vaccine,” she says. “I haven’t seen a case of chickenpox in years because we vaccinate people. Nobody should suffer like I did when I was 3 with chickenpox, right? We’ve seen the same thing in HPV.”

Trent urges decoupling the vaccine from sex, which prevents some physicians from administering it.

“I don’t think you have to have ‘the talk’ to give your kid the HPV vaccine. It’s just not a requirement,” she says. “No one is going on tangents about your Tdap [a vaccine to prevent tetanus, diphtheria and whooping cough], you know, other than to say, ‘If you step on a rusty nail, this is going to help you.’”

The vaccine is also recommended for boys because it protects against HPV transmission as well as anogenital, penile, and head and neck cancers. “The data suggests there are risks for subsets of men related to cancer,” Trent says, “and we want to prevent people from having genital warts, too.”

Make sex education part of family conversations

Researchers discovered the link between HPV — the most common sexually transmitted infection — and cervical cancer in the 1990s, around the time I first attended sex education in public school. But, like most women, I never learned about this in school. Instead, I found out about the link after my HPV diagnosis.
“You can’t leave the conversation about the first menstrual event to somebody else,” says Simelela of the WHO. “Make it something that the family talks about like we talk about their grades, their performance on the sports field. You’ve got to make this a day-to-day conversation. That’s what I tell a mom, that ‘it’s your responsibility … It’s you, at the end of the day, you take responsibility for this and for the well-being of your child.’ ”

“We spend billions of dollars on STD [sexually transmitted disease] management and unplanned pregnancies in the United States; the least we can do is tell young people how to take care of themselves, how to prevent adversity down the road,” she says. “If they don’t have that information, they can’t incorporate that into their decision-making.”

Navigate difficult topics with trusted health-care providers

As a young adult, I went to my first gynecology appointment alone, unprepared for the stark difference from seeing my pediatrician. Lacking the language to comfortably discuss sexual health, I only sheepishly spoke up. After cancer, I realize that being afraid to ask questions can affect the care patients receive and doctors can administer.

Now I view my health as a trusted partnership between myself and my provider, and that’s a value my husband and I instill in our children. At home, we talk as a family about the many reasons to visit the doctor. Eventually, we’ll discuss what my cancer diagnosis means for the kids as they grow up and independently seek care.

Find a pediatrician or adolescent-medicine provider with whom your child is comfortable discussing difficult topics.

“I would also say to parents that it’s important for them to allow their young person space when they need to talk to [their doctor],” Trent advises, “knowing that we always would loop parents back in if their young person is in trouble.”

Rose, the Bellevue OB/GYN, says gynecologists are working to improve the care continuum from adolescence into adulthood. “There’s been a move in our specialty to make the transition smoother,” she says. “For patients, there’s a lot of normalizing why women go to the gynecologist. There are plenty of reasons to see a gynecologist, even if you’re not sexually active.”

For parents, there’s no end to the child-rearing advice we receive. Having just survived cervical cancer, I believe this may be the most important: Give your child the gift of life that preventable cancer won’t cut short.

As Simelela of the WHO says: “Here you may have such a unique opportunity to leave a legacy for the next generation where they can never experience this painful disease, and instead read about it in a museum. It’s possible.”

Complete Article HERE!

Managing Expectations About Chemotherapy and Sex

by Angelica Bottaro

Chemotherapy and sex is a subject that many people may wonder about when they’re undergoing treatment, but oncologists rarely discuss sexuality and physical intimacy during chemotherapy with their patients.1

Since it’s not talked about, many people have a knowledge gap about the safety of sexual activity during cancer treatment and the ways in which their sexuality might be affected by it.

Read on to find out more about how chemotherapy can affect your sex life and how to stay physically intimate with your partner while undergoing cancer treatment.

Is Sex During Chemo Safe?

Having sex while you are undergoing chemotherapy (or chemo) is generally considered safe as long as certain precautions are taken. Patients receiving chemo can typically have sex, but they need to do their best to avoid situations that could affect their treatment or overall health.1

Infections

You may develop a low white blood cell count while you are undergoing chemo.2 This makes you more open to infections. Having sex if you have a lowered white blood cell count places you at risk for infections.

Chemotherapy can also decrease the number of cells that bind together in your blood (platelets) to help form blood clots and prevent excessive bleeding.

If you have sex and you have low blood platelets, you might experience bleeding that could be severe. You might also be more likely to bruise during intercourse if you have a low blood platelet count.3

When to Talk to Your Healthcare Provider

Ask your healthcare provider about getting blood tests to check your white blood cell and platelet counts to help determine if it’s safe for you to engage in sexual activity while you are undergoing chemotherapy.

Exposure

Chemotherapy drugs can make their way into saliva, semen, and vaginal secretions for up to three days following treatment. It is not clear whether chemotherapy medications can be passed sexually, but you might be more likely to expose a partner to the chemicals in chemotherapy medications if you are intimate during the first few days after treatment.

People who are not undergoing chemotherapy but who are exposed to chemotherapy medications may experience adverse health effects such as:4

  • Skin rashes
  • Sore throat
  • Chronic cough
  • Dizziness
  • Headaches
  • Eye irritation
  • Hair loss
  • Allergic reactions
  • Increased risk of developing cancer
  • Infertility
  • Miscarriage

Considerations

Depending on where the cancer is located, you might be told to avoid sex while the area is healing. For example, you might need to avoid sexual intercourse if the cancer is in your genital area, urinary tract, or rectum.

Chemotherapy may lead to painful intercourse (dyspareunia).5 You may not experience pain, but if you do, be sure to bring up this concern with your doctor. There are ways to address the pain and make intercourse more comfortable.5

One study in women being treated for breast cancer found that when they used a liquid lidocaine compress on their genital area prior to sexual intercourse, it helped treat the pain they had been having during sexual intimacy.5

Protection, Fertility, and Pregnancy

If you plan to have sex while you are receiving chemo and you could become pregnant, you need to use birth control. Getting pregnant during chemotherapy can be risky because the medication increases the chances of birth defects in the developing fetus during the first trimester.

Undergoing chemotherapy during the second and third trimesters has been associated with low birth weight and an increased risk of stillbirth.6

Getting Pregnant After Chemo

In some cases, chemo can cause infertility. However, many people do go on to have children after treatment.7

If you want to conceive and have recently had chemo, you should talk to your doctor about when it will be safe for you to stop using birth control and begin trying to get pregnant.

How Chemo Affects Libido 

Chemotherapy can disrupt your sex drive and cause low libido. While this side effect of treatment is rarely talked about, it can severely affect your intimate relationships.8

Sexual side effects are not seen with every type of treatment. They’re more often experienced by people who are being treated for specific cancers, such as prostate cancer, testicular cancer, and gynecological cancer, including cancers affecting the cervix, ovaries, and uterus.9

Chemotherapy medications, in particular, have been associated with a lowered libido and can affect a person’s libido in several ways, including:

  • Medication side effects: Chemotherapy has been shown to cause low libido. Other side effects such as nausea, vomiting, and fatigue can also contribute to a lower sex drive.10
  • Body Image: Chemotherapy side effects can affect a person’s body image because of weight loss or gain, and hair loss. A person may develop low self-esteem because of these changes, and the way that a person sees themselves has a lot to do with their desire to be intimate.11

Staying in Touch With Your Sexuality During Chemo

Although chemotherapy can hinder your ability or desire to stay intimate with your partner, there are things you can do to help improve the experience.

Open the Lines of Communication

If you no longer desire sexual intimacy but do not discuss the change with your partner, they may feel rejected and unloved. You will want to be open and honest with each other about how your treatment has affected the physical aspect of your relationship.

Having open communication can also help you brainstorm solutions to maintain a level of intimacy that is satisfactory to both you and your partner.

Partner Play

When you and your partner are ready to try being sexually intimate again, it’s important that you ease into it. Make use of any ideas you had in your earlier discussions.

Remember that there is more to physical intimacy than intercourse. Exploring new ways to be with someone physically can be a fun and exciting opportunity to reignite your desire for sexual touch. If you’re having pain, try different positions that make intercourse more comfortable.12

Going Solo 

Sometimes it might be difficult or undesirable to be intimate with someone else. When you are feeling this way, you might want to explore your sexuality independently.

According to the American Cancer Society, self-stimulation can help ease you back into sexual feelings as you are recovering from chemotherapy.

It can also help you identify any areas on your body that might be sore or tender. That way, when you do go to have sexual intercourse, you will be aware of what hurts and you can communicate about these sensitive areas beforehand.12

Resources

One resource that you might explore with a partner is couples counseling, which can give both you and a partner insight into how the other person is feeling about the current state of your physical relationship.

Sometimes it’s helpful to have someone else mediate conversations if the topic is sensitive. In this case, a sex therapist could help you identify and fix obstacles that have been preventing you from expressing yourself sexually.

Seeking out a therapist who can help you overcome any body image challenges that you have after cancer treatment can help you rebuild your self-esteem. This, in turn, could increase your drive to be physically intimate.

According to the American Psychological Association, there are many avenues that you can explore to help address lowered libido and sexual dysfunction caused by chemotherapy.13

For example, you might try mindfulness-based approaches, psychotherapy, and couples therapy with a partner.

Summary

Sexual dysfunction is a side effect of chemotherapy that can cause a person to feel worse about themselves, which may result in problems in romantic relationships.

Aside from the physical changes that may come with treatment, such as lowered libido, having sex while you are undergoing chemo can also pose extra health risks, making it even more difficult to participate in.

If you are having chemotherapy, you should express your desires, needs, and concerns about sex to your healthcare providers to ensure that they can help you regain your sexual life after treatment. Your provider might also be able to help you connect with a sex or couples therapist.

A Word From Verywell

Dealing with a lack of sexual intimacy in a relationship can be tough, but it can be even more difficult if it’s the result of an already stressful situation like cancer treatment.

You might find it challenging to help your partner understand what you’re going through. Not being able to be physically intimate with them may put a strain on your relationship.
Know that you can have sex while undergoing chemotherapy as long as your healthcare provider says that it’s safe and you understand the precautions that you need to take to keep things safe.

Communicating openly with your partner, exploring new ways to be physically intimate, and asking your doctor any questions you have about physical intimacy during chemotherapy can all help you maintain the physical aspect of your relationship with your partner and yourself both during treatment and when you are recovering from it.

Frequently Asked Questions

  • Should you wait to have sex after chemotherapy?

    Some people are advised to avoid sex while they are having treatment, but this is not the case for everyone. Ask your healthcare provider about whether it is safe for you to have sex during your treatment.

  • Can you still become aroused during chemo?

    Although it’s possible to lose your libido during chemotherapy, not everyone will experience this side effect. If you do, there are still ways to become aroused while your desire for sexual intercourse is low.

    For example, playing out fantasies in your head, practicing different forms of intimacy with or without a partner, and fostering good self-esteem can all be helpful.

  • What should you avoid after chemotherapy?

    When you’ve reached the end of treatment, you might be ready to jump back into sexual intimacy—but there are a few things to be aware of.

    For example, if you get pregnant shortly after you are done with treatment, there is a risk that the fetus will have birth defects. If you are able to become pregnant, you will probably be on birth control during treatment to help prevent this.

    After you’re done with chemo, talk to your healthcare provider if you are planning to resume sexual activity and wish to go off birth control, especially if you would like to try to conceive.

  • How long after chemo can you have a baby?

    Getting pregnant shortly after chemotherapy comes with risks for the developing fetus. Some health experts believe that you should wait at least six months after finishing your treatment to begin trying for a baby. Other health experts have said that two to five years is the optimal time to wait before getting pregnant after you’ve had chemotherapy.

    Discuss your posttreatment conception plans with your healthcare provider, as they will be able to give you the best recommendation based on your situation.

Complete Article HERE!

How Cancer Changed My Sex Life

By Elizabeth Bennett

When Rebecca, 31, was diagnosed with breast cancer in early 2019, her sex life with her partner was a welcome distraction. “We were like teenagers again. There’s nothing like being faced with your own mortality to make you want to feel alive and nothing makes you feel more alive than having sex,” she said. “With cancer I felt let down by my body and sex became a way of reconciling myself with it. It became a psychological thing I needed to do,” she added.

However, when Rebecca started chemo, the treatment affected her sex life. Specifically, she suffered from vaginal dryness and then vaginismus, a condition where the vaginal muscles tighten up, preventing penetration. “When I asked my doctor about whether it was a side effect of chemo, she didn’t know how common it was because no one talks about it.”

Although one in two people in Canada will be diagnosed with some form of cancer during their lifetime, its impact on sex and intimacy is rarely talked about in the medical field, let alone wider society. Naturally, going through cancer treatment impacts your sexual life in myriad ways. “The most common difficulties for women I see are loss of sexual desire, difficulties becoming sexually aroused or vaginal changes such as pain,” explained Isabel White, a COSRT senior accredited psychosexual therapist who specializes in working with people who have or have had cancer.

Issues stem from both the physical and the mental repercussions of treatment. “It can be a physical origin such as treatment-induced menopause that’s very common after hormonal breast cancers, or mental health issues. Low mood and anxiety are two conditions found more commonly in cancer patients versus the general population and these have a significant adverse effect on sexual wellbeing.” Body changes can have a huge effect too. “Hair loss, weight change or loss of body parts associated with eroticism can adversely affect body confidence and the ability to connect with people when being sexually intimate,” Isabel added.

For Bronte, who was diagnosed with leukaemia aged 21, the physical toll of her illness made continuing her sex life with her boyfriend of two years really hard. “I was often exhausted when I was able to see my partner, or just really ill, and the last thing on my mind was taking my clothes off. With so many changes happening to my body I experienced a lot of body image and identity issues which made me hate myself a lot of the time and feel completely disconnected from what I saw in the mirror. This really impacted our intimacy because I simply didn’t feel comfortable in my skin, let alone feel sexy.”

The practical elements of being ill were tricky to navigate, too. “We were both at uni so when I was diagnosed I went back to my parents’ for treatment, which meant we were a three-hour journey away from each other,” Bronte explained. Rediscovering her sex life has been a long process. “Three years later I’m still slowly rebuilding and discovering new interests and desires. As I discovered myself again and recognized my reflection I became more confident and the intimacy naturally followed. It did take an extremely long time for my libido to build back up and I’m so lucky to have a super supportive partner who stuck with me through it all.”

Some cancer patients are advised to avoid sex altogether. Maria, who was diagnosed with leukaemia aged 17, was told to completely refrain from any sexual activity due to the risk of infection. “It was like a hypothetical chastity belt,” she said. Single at the time, she found her libido had ​​also completely diminished. “Previously I would think about romance and sexual activity a lot but that completely disappeared,” she added. During this time she also worried about how she would date again. “I started to get depressed thinking about it and thought I wouldn’t be good enough for anyone again since I didn’t think I could ‘perform’ or live up to a guy’s expectations.”

Kimia, now 30, also struggled with dating after suffering from non-Hodgkin lymphoma aged 21. “At first I was worried about dating again but as my confidence increased after coming out as bi, I thought, This is me, and if prospective partners act weird about my cancer history, then whatever. As soon as people see my scars, I tell them the full story,” she explained. “Luckily, I’m now in a loving relationship with someone who doesn’t treat me differently,” she added.

For some women, reconnecting with their sexuality after cancer is made harder by the drugs they are prescribed to prevent cancer from returning. Joon, who was diagnosed with breast cancer aged 37, has to take tamoxifen for up to 10 years. This very commonly prescribed drug induces early menopause. “It feels like your most intimate life – your skin, sexuality and intimacy with your partner – go out the window. You feel like an old woman,” she told us. “I had a healthy sex life before but suddenly I didn’t want to have sex anymore. Vaginal dryness is also a real bummer.”

Unlike male treatments (for example, Viagra), there are fewer options for women in terms of drugs that can improve sex life. Like so many areas of female health, the gap here is significant. “It’s harder to get funding for research into sexual difficulties in women versus men as a lot of money comes from pharmaceutical companies,” Isabel points out.

In 2010, Isabel was appointed by the Royal Marsden in London (the UK’s top cancer hospital) as its first in-house psychosexual therapist – a position created in response to patient demand. Therapists like Isabel are available in some NHS hospitals but not everywhere or for everyone going through cancer. With cuts to NHS funding, these sorts of services are often the first to go. Alongside the need for greater sexual health resources, Isabel highlights the importance of more research into this area, especially from a female perspective.

The lack of knowledge in this field comes up again and again when I speak to women who have had cancer. Twenty-four-year-old Lynsey was surprised by how little information about contraception was provided when she was diagnosed with breast cancer at the beginning of 2021. As her cancer was hormonal she had to stop taking the contraceptive pill. “They make it really clear you can’t get pregnant during your cancer treatment but no one gave me much advice on alternatives. In the end I phoned the sexual health services, who suggested the non-hormonal coil,” she explained. When Lynsey started chemo, she also struggled to find information about safe sex practices. “It’s suggested you use condoms because of the drugs going around your body but no one seems to really know whether that’s just straight after chemo or up to a week after,” she said. “It’s concerning that there is not more research or information on this,” she added.

Finding support can be life-changing. During her treatment for leukaemia, Maria had access to a women’s health clinic run by a nurse with whom she felt comfortable discussing her sexuality. “Although the information was catered to older female patients, it still gave me some confidence. If it wasn’t for that nurse’s advice I don’t think I would have the confidence to dive back into masturbation or dating.”

Thanks to some women, the narrative around sex and cancer is hopefully set to change. “We need to talk about it so women don’t feel embarrassed and the medical community knows it’s an important issue,” Rebecca explained. As a producer at ethical adult filmmaker Erika Lust, Rebecca decided to use her position to change the current conversation.

“I wanted to make a film about cancer without death. Culturally we are 30 years behind where we are with cancer medically. We still see cancer as a death sentence and it’s just not the case,” she said. After all, there’s an 87% survival rate for young people experiencing cancer. “Sex in society is one taboo, female sexuality is another taboo, put on top of that sexuality when [you have cancer] and it’s a triple taboo,” she said. Inspired by her own experience, Wash Me is an intimate and hopeful portrait of a woman rediscovering her body and desire after cancer. The film aims to raise awareness of the intimacy struggles faced by people with serious illnesses while inspiring others who are going through cancer treatment not to give up on their sexuality but claim it back.

Joon also aims to shift the narrative with her platform sexwithcancer.com. Created with friend, fellow artist and former cancer patient Brian Lobel, it’s a sex shop, a resource for peer-led advice, a platform for artist work and a place to explore journeys around cancer that are harder to dive into. “We need to start thinking about cancer as a chronic condition like mental health or diabetes. We need to think beyond survival about how we live more fully as whole human beings,” she explained. “Pleasure and intimacy are so much about life and what is the point in living if you are just surviving?”

Complete Article HERE!

What No One Tells You About Sex After Breast Cancer

Treatment can rob women of their breasts, libidos, and self-confidence — here’s how they’re reclaiming their sex lives in the face of it all.

By Jessica Zucker

Carmen Risi, 40, knew there was a good chance she’d one day sit across from a doctor and hear that she had cancer. Her grandmother died from breast cancer, her mother and aunt were both diagnosed with ovarian cancer, and in 2019 she found out she was positive for the BRCA1 gene — an inherited variant that puts people at a much higher risk of developing certain cancers. As a result, Risi spent two years undergoing routine cancer monitoring — every six months, she’d receive an MRI or a mammogram.

In April of 2021, one such MRI found what Risi would later learn was breast cancer.

In addition to six grueling rounds of chemotherapy, Risi decided to take a hormone therapy shot, in order to preserve her fertility in the hopes of soon growing her family — she started IVF before treatment began and has plans for an embryo transfer once she’s done.

One major side effect of the drug? The loss of her sex life as she knew it.

“Lupron has put me into a temporary menopause — complete with hot flashes and a vagina that has completely atrophied,” Risi explains. She wasn’t exactly given a heads up, either. “I have pages of notes about the side effects these various drugs will have on me that I was handed by my doctor,” Risi says. “But there were no notes on how it would affect my sex life. None.”

Shari Goldfarb, M.D., an oncologist specializing in breast cancer at Memorial Sloan Kettering Cancer Center, says many women simply don’t realize the sexual side effects that come along with various breast cancer treatments. That’s why she makes sure to discuss with her patients, upfront, the possibility of menopausal symptoms and sexual challenges, such as vaginal dryness and decreased libido. She also encourages her patients to be proactive by using non-hormonal moisturizers, lube, vaginal dilators, and vibrators to make them feel more comfortable about having penetrative sex when they’re ready.

But the emotional side effects can be just as jarring. The temporary menopause combined with the loss of libido thrust Risi into a deep depression that she says left her thinking, “‘What’s wrong with me?'”

Madeline Cooper, LCSW, a psychotherapist and certified sex therapist, says it’s common for cancer patients to experience depression — as well as other mental health struggles — as a result of receiving a cancer diagnosis. “The first thing I tell my clients is that it is normal to go through a grief and mourning period,” Cooper tells InStyle. Being slapped with a breast cancer diagnosis that, for some, is intimately wrapped up in one’s identity as a woman, can affect so many parts of her life: a change in her body, expression of sensuality, sexual desire, pleasure, body image, the list goes on. “You might need to adapt to a new sexual style with your partner, and this might feel like a loss.”

Of course, not everyone already has a committed romantic partner in their life when they receive their cancer diagnosis and undergo treatment. Chiara Riga was a single 27-year-old when she was told last year that she had stage 4, metastatic breast cancer. While her healthcare providers believe she has between 10 to 15 years to live, her diagnosis is terminal, which, needless to say, makes dating — and sex — particularly fraught.

“I’m casually using dating apps, but there are so many different layers to what makes it a struggle for me,” Riga tells InStyle. “There’s the first layer, which is zero libido. Kids are off the table for me, too — certainly biological kids, but there’s also the ethics of adopting a child knowing that my disease is terminal. Then there’s the issue of ‘when do you disclose?’ and ‘how do I disclose?’ I want to date in order to be able to escape this dark reality I’m living in.”

Part of Riga’s treatment, which she will undergo until the end of her life, suppresses her ovaries and estrogen, because her cancer is hormone-fed. This means she is in full-blown menopause, which has essentially eradicated her desire to have sex. And while Riga says she actually doesn’t miss it, the want and ability to have sex would make her dating life much simpler and a hell of a lot more fun. Breast cancer, in a sense, has eliminated frivolous sexual encounters, by shifting the focus from sexual pleasure to long-term support through partnership.

“Who in their late twenties or early thirties is looking for ‘just a partner’? I think [wanting to have sex] would make dating much easier for me,” she explains. “And I do think for the right person, the right relationship really, I’d try to figure something out. I just haven’t found the right person for that yet.”

Even for those who do have a long-term partner — and a libido — to navigate the process with, redefining what sex looks like after breast cancer takes effort. For Risi, that meant finding other ways to experience orgasm (ahem, clitoral stimulation) with her partner once penetrative sex became too painful during chemotherapy. And after her forthcoming double mastectomy, Risi knows she’ll have to contend with not just the loss of her breasts, but the sexual pleasure they bring her. “I don’t want to lose my breasts. I don’t want to lose feeling. My breasts [stimulate me sexually], so to lose that forever is incredibly daunting,” she says, despite knowing it’s the best decision based on her risk factors.

According to Cooper, this reaction is common. Cancer treatments can often be associated with many types of “loss” — be it loss of libido, breasts, hair, a sense of sexiness, comfort in one’s body, identity even — and that loss, even if some are temporary, can be overwhelming at best.

“Breasts and hair can [contribute to] a woman feeling sexy and confident about her body, and this might shift with the loss of either,” she explains. “These changes could cause one’s body image to become a source of feeling turned off rather than turning herself on, and this can reduce sexual desire overall.”

Learning to love her body and reconnect with her sexual desire is something that Mary Purdie, 38, was already contending with when she was hit with the whiplash of breast cancer in January of 2018. In fact, it was during a new morning ritual — looking at her naked body in the mirror — that she first noticed a lump in her breast. “I was trying to appreciate my body, even though it was causing me so much pain,” Purdie tells InStyle.

After she was diagnosed with stage 1A invasive ductal carcinoma, she underwent a lumpectomy, radiation, and multiple rounds of chemotherapy. She was also put on a long-term hormone-blocking treatment called tamoxifen — a daily oral medication she has to take for at least five years. And while she was able to keep her breasts, and therefore felt more physically “whole” — her libido went out the window.

“Our sex life was already kind of on shaky ground after the last miscarriage, because my body had gone through so much and most of the sex that we were having in the past year or two was strictly for the sake of conceiving and not really for pleasure in any sort of organic way — it was scheduled,” Purdie explains. “So going from that to cancer treatment, it was like, ‘Well, how do we even get back to the honeymoon phase?'”

For Purdie, it was by allowing her husband (of three and a half years at the time) to take care of her. “I was generally the person who was cooking and cleaning. I took care of our house. But that all changed when I was going through chemo — he did everything all of a sudden,” she says. “And those acts of service helped to build intimacy. I could just lay there and be miserable and I knew he was going to take care of me, and that was such a huge showing of his love.”

According to Dr. Goldfarb, experiencing this kind of non-sexual, emotional support from a partner tends to increase the amount of intimacy a patient feels during and after treatment — and can indirectly benefit their sex life too. “Assurances like ‘I love you unconditionally’ and ‘I’m in this with you — I am here to support you through this’ are really important, because patients often worry that a cancer diagnosis will [damage] their relationships,” Dr. Goldfarb adds. “I have seen relationships get closer in times of turmoil and illness when significant others are supportive.”

She says that in addition to simply being there — reminding her to take her medications, sitting with her through chemotherapy treatments, cooking, cleaning — her husband’s patience and attention to the little things also helped, not just in making her feel closer to him but making her feel more comfortable in her body and, eventually, being sexual. He deferred to her in bed — he let her take the lead.

“In the evenings it would often turn into a moment together that, even if it was brief, was a chance for us to be physically intimate,” she adds. “It felt good to tap into that sense of normalcy that we had before cancer and before miscarriages.”

Risi is also determined to maintain her sex life — no matter what changes to her body breast cancer may bring. She grew up in what she describes as a conservative Christian community where women were “taught to be modest” and that “sexuality wasn’t something you should even think about until you’re married.” Risi got married at 28, and says that, as a result, she spent years muting her own sexuality.

“I’m so mad that I lost a part of my sexuality to religion in my youth, and I’m losing sexual function and desire to cancer. It’s maddening,” she adds. “But I know my husband will still want to love and touch on whatever my new breasts are, even if I don’t have a specific feeling there. And I think I will enjoy that, because there’s intimacy there, even if there isn’t sensation.”

Complete Article HERE!

5 common conditions that can lower sex drive

By Charlie Williams

The science is clear: Sex can bring some incredible benefits for your health. Study after study has shown that having sex regularly can improve longevity, reduce the risk of heart disease, stroke, and certain types of cancers, bolster the immune system, improve sleep, enhance mental health, reduce depression symptoms, and improve overall quality of life.

Common conditions, like cancer, diabetes, heart disease, etc, not only affect patients’ physical health, but also their sexual health.

Despite this, sex remains a taboo topic in American culture. We don’t even know how to address it to children in schools. For instance, in the late 1990s, the US government adopted the abstinence-only-until-marriage (AOUM) approach to adolescent sexual and reproductive health. Public schools in 49 of 50 states accepted federal funding from this program. As a result, public school sex education focused on raising awareness of the risks of sex, like sexually transmitted infections and youth pregnancy, rather than balancing the risks with the scientifically supported benefits. What’s more, rigorous research showed that AOUM failed to achieve its goal of delaying sexual initiation, reducing sexual risk behaviors, or improving reproductive health outcomes.

The history of American inhibitions about sex is too complex to detail here. Suffice to say that because of these longstanding cultural mores, modern public discourse about sexuality is often described in a negative light, focusing on the risks and dangers of sex. Meanwhile, discussion about the physiological and psychosocial health benefits of sex is commonly ignored, according to a white paper from Planned Parenthood.

This discussion might be missing in physician’s exam rooms, too. Six in 10 American adults have chronic disease, but it’s likely that they aren’t receiving sufficient education to help them cope with the effects that their conditions can have on their sexual health, and how those effects can change their quality of life. The problem becomes more challenging when considering that cultural mores prevent patients—and physicians, too—from broaching the subject simply because it’s uncomfortable to talk about.

So, next time you suspect a patient has one of these conditions, consider spurning the taboos and help them understand its implications for their sexual health and overall quality of life.

Cardiovascular disease

According to the American Heart Association, decreased sexual activity and function are common in patients with cardiovascular disease (CVD), but not for the reasons you might expect. Patients with CVD often endure psychological distress because of their conditions, which is correlated with negative downstream effects on sexual function. In patients with coronary artery disease, heart failure, congenital heart defects, recent heart attacks, coronary artery bypass grafting, implantable cardioverter defibrillators, and cardiac transplantation, sexual activity frequency and satisfaction often decline because of the anxiety that sexual activity will worsen the underlying cardiac condition or cause death. That anxiety can lead to depression, an important contributor to erectile dysfunction (ED) and decreased libido.

While some patients with severe CVD may be putting themselves at increased risk for complications by having sex, doctors can clear many patients for sex after a simple physical exam or exercise test. For those with depression, anxiety, or decreased libido, physicians can recommend patient and partner counseling, refer to psychiatrists, or prescribe medication.

Diabetes

Long-term poor blood sugar control can damage nerves and blood vessels, inhibiting feeling and the blood flow that is necessary to maintain an erection, according to the Mayo Clinic. As such, some male patients with diabetes are likely to experience ED while managing their condition. Other conditions that are common in men with diabetes can commonly cause ED, like high blood pressure, heart disease, and depression.

Women with diabetes are also likely to experience decreases in sexual function, including reduced libido, decreased vaginal lubrication, and reduced or absent sexual response, including the ability to stay aroused, achieve an orgasm, or maintain feeling in the genital area.

The good news is that diabetes can be a preventable condition, and sometimes reversible in those who have already developed it. Many of the factors that cause symptoms that reduce sexual function and desire in patients with diabetes can also be reversed. Plus, many of the factors, like improving blood sugar levels, have the added benefit of helping patients feel better overall and improving their quality of life.

Obesity

While the health hazards of obesity have been thoroughly studied and are well known to most patients, its effects on sexual health are not frequently discussed. For instance, obesity in men reduces testosterone levels and increases the likelihood that men will experience ED. Moreover, obesity can have negative impacts on fertility—it has been linked to low sperm counts and reduced sperm motility, both of which have been shown to make men less fertile.

Women who are obese experience similar reductions in sexual health. Researchers have shown that obese women have lower sexual function scores, and that weight reduction seems to improve sexual function in young obese women. Moreover, obese women are 4 times more likely to experience an unplanned pregnancy than normal weight women, despite them reporting lower rates of sexual activity.

As with diabetes, the good news is that obesity is a preventable condition. And just like diabetes, reducing obesity will not only bring beneficial effects to sexual health, but to overall health as well.

Cancer

Many types of cancer can have detrimental effects on sex to varying degrees. “Some surgeries and treatments might have very little effect on a person’s sexuality, sexual desire, and sexual function,” according to the American Cancer Society. “Others can affect how a certain body part works, change hormone levels, or damage nerve function that can cause changes in a person’s sexual function.”

Doctors, caregivers, and partners can help patients with cancer confront issues of sexual health by maintaining discretion, helping to talk through emotional issues, helping address problems with self-esteem, and tracking side effects. 

On the upside, sexuality and intimacy have been shown to help patients with cancer bear the burden of their disease by helping them cope with feelings of distress.

Mental health disorders

Healthy and intimate sexual relationships are a key component of mental well-being. But, common mental health problems like anxiety, depression, personality disorder, seasonal affective disorder, and bipolar disorder can all have detrimental effects on sexual health.

Notably, a markedly decreased sex drive is a common indicator of major depressive disorder, according to Jennifer L. Payne, MD, director of the Women’s Mood Disorders Center, Johns Hopkins Hospital, Baltimore, MD.

“Change in sex drive is a key symptom we look at when deciding if someone fits the diagnosis for major depressive episodes,” Dr. Payne wrote. “A primary symptom of depression is the inability to enjoy things you normally enjoy, like sex.”

But mental health disorders don’t exclusively cause a reduction in sex drive and performance. Some individuals, including those with compulsive sexual behavior, can become consumed by sexual thoughts and an out-of-control sex drive. Like most addictions, when sex addiction and compulsive sexual behavior is left untreated, it can damage self-esteem, relationships, careers, and health. 

Time to have ‘the talk’

Both the patient and physician may feel uncomfortable in the exam room broaching the subject of sex. But, consider that studies have shown that most patients with CVD believe they haven’t been appropriately educated about their conditions’ effects on sexual health and desire more information on how to resume their normal sexual activity. Other patients with common conditions most likely feel the same way. 

Having an open discussion or referring patients to counseling can go a long way toward improving sexual health, which in turn can provide both physical and mental health benefits.

Complete Article HERE!

How to talk to your doctor about sex and cancer

Sexual health is important for every adult — Here are tips for starting the conversation

By Sara Thompson

Sexual health is important for any adult’s well-being, but patients with cancer face a new set of challenges when it comes to sexuality. Laila S. Agrawal, M.D., breast cancer oncologist with Norton Cancer Institute, is spearheading efforts to develop a sexual health clinic at Norton Healthcare.

“The World Health Organization says that sexual health is fundamental to the overall health and well-being of individuals, couples and families, and that this is relevant throughout the individual’s lifespan, not only in reproductive years,” she said.

Cancer’s effects on sexual health

“When we are thinking about sexual health and sexual dysfunction, we look at the big picture,” Dr. Agrawal said. “So many domains affect the body’s sexual function. From hormonal changes, loss of sensation and mastectomies, to changes in body image and low libido, cancer patients face myriad symptoms and experiences.”

Sexual health is the third most common concern for cancer survivors, and issues are associated with poor quality of life and mood disorders. Yet, many doctors are reluctant to bring up the subject, or the cancer diagnosis takes precedence over every other aspect of the patient’s life.

“Sexual health issues caused by cancer and treatments do not magically disappear on their own,” Dr. Agrawal said. “The more I talked to my patients about this, the more I learned. This is a medical issue we need to address.”

How to talk to your doctor

Ask about sexual health and acknowledge its importance.

Despite being such a prevalent and important issue, it often is not discussed with physicians.

In a 2020 survey of over 400 cancer patients (most of them female), 87% of patients said cancer treatment impacted sexual function and/or desire, including pain with sex, body image distortion and the inability to achieve orgasm. Only 28% had been asked by a medical provider about sexual health, and female patients were less likely to be asked than male patients.

It’s normal to feel anxious about bringing up sex, sexual health and sexual function with your medical team. Your health care professionals care about you and your quality of life. They can help you or refer you to another professional who can.

Here are some ways to talk to your doctor about sexual health:

  • Prepare a statement for your doctor before your visit. It could be, “I have concerns about my sexual health,” or “I have symptoms I’d like to talk about.”
  • Be specific. For example, you can mention your level of interest in sex, or say if you have vaginal dryness or pain with sex.
  • Use resources. Magazine articles, stories from friends with similar issues or other related items can get the conversation going.

Self-reporting checklists

A number of checklists have been developed for use in cancer clinics. You can use these to self-assess and begin a conversation with your doctor. These are short surveys, typically beginning with a general question such as “Are you satisfied with your sexual function?”

What you can do right now

  • If you are having any sort of sexual issues related to your health conditions or treatments, make an appointment with your doctor. Use the tips above to start the conversation.
  • Communication is key, not just with your doctor, but your partner as well. Ask for what you need and share your feelings. Your partner may not be aware of changes you are experiencing.
  • Get creative with intimacy. Sex isn’t the only way to be close. Explore new ways to create intimacy with your partner.

Complete Article HERE!

Think You Can’t Have Good Sex After a Chronic Illness Diagnosis?

Think Again!

Your sex life shouldn’t be halted because of bad advice, embarrassed doctors, or a lack of knowledge.

by Amy Mackelden

Receiving an unexpected diagnosis can affect every aspect of your life, including your sex life.

There are so many misconceptions when the topics of chronic illness and sex converge, making it a potentially scary subject for anyone learning to live within their “new normal.”

I was diagnosed with relapsing-remitting multiple sclerosis (RRMS) 2 weeks after my 30th birthday, and I had a plethora of questions on my mind, some of which involved my sex life.

Multiple sclerosis (MS) is a chronic condition in which a person’s nervous system attacks itself, creating lesions on the brain and spine, often damaging the nerve pathways. This can result in numbness, tingling, itching, nerve pain, spasticity, mobility changes, and many other symptoms.

As a result, I knew my sex life was going to change, but I had no idea how.

It took some time, but I eventually discovered it was possible to have a satisfying sex life while living with a chronic illness and disability.

It might seem obvious to anyone who’s living with a lifelong condition or disability that sex is often an important aspect of our lives. However, when it comes to seeking medical advice following a life altering diagnosis, sex regularly goes unmentioned.

Research shows that many healthcare providers have limited knowledge of and confidence in talking about sexuality and chronic illness and disability. They’re also commonly really uncomfortable bringing it up with patients.

Meanwhile, research is limited on sexual dysfunction related to chronic illness. It makes sense, then, that some medical professionals may be uncomfortable addressing the subject with patients.

However, this lackluster response can sadly make those of us with chronic conditions feel as though we’re asking too much, or that the support we need just isn’t available.

If, like me, you’ve broached the subject of sex with a medical professional, it’s likely that you’ve also had mixed results.

Some suggestions have been helpful, from “use more lube” to “have sex earlier in the day to avoid fatigue.”

Others have made me question whether my sex life is important, and more specifically, if anyone else believes that my sex life is worth saving.

However, it’s crucial to find the right healthcare provider who understands the unique needs of someone facing a difficult diagnosis or lifelong condition.

It’s impossible to explore all of the ways that a chronic illness or disability might affect a person’s sex life, especially as each individual will be affected differently.

After finding out that I have MS, my sex life changed, first for the worse, and then for the better.

I had a major relapse that affected both of my legs and caused numbness from the waist down. This made sex an uncomfortable experience for several months afterwards, and I lost the ability to feel orgasms.

There were times I wondered whether I’d ever experience an orgasm again. Sex itself felt strange and made me tingle all over, not in a good way.

My body has also been affected by pain, mobility changes, and fatigue, but I’ve persevered in spite of any difficulties because I didn’t want to give up on having a sex life.

While I’ve spoken to some wonderfully supportive doctors and medical professionals, it’s also been suggested that companionship is more important in a relationship and that I should make the most of what I have, even if it doesn’t involve sex.

The implication, of course, was that sex was somehow less important to a person with an incurable illness, but that’s simply not the case.

When it comes to disability, people often speak of accessibility, so why shouldn’t the same parameters extend to having sex?

Here are some of the things that might make sex more accessible (and more fun!) if you’re living with a chronic illness.

Communication is key

While it might sound obvious, communication is key in any relationship.

“Some people believe that if two people love each other, sexual activities should automatically feel mutually wonderful and satisfying,” says Lee Phillips, EdD, LICSW, a licensed clinical psychotherapist and AASECT certified sex therapist.

“The number of sexual problems reported by people with chronic illness demonstrates all too conclusively that there is nothing automatic about sex,” says Phillips.

It’s all too easy to feel frustrated when sex and intimacy don’t magically happen the way we want it to.

When one or both partners in a relationship have a disability or chronic illness, it’s more important than ever to talk through any issues or concerns there might be.

For instance, sometimes my condition affects my ability to physically feel anything during penetrative sex, and I always let my partner know about any new symptoms or changes I’m experiencing.

“Sexual communication is critical because it can address sexual likes and dislikes, turn-ons and turn-offs, sexual needs and desires, sexual fears and concerns, past positive sexual experiences, and past negative sexual experiences,” says Phillips. “It is the key ingredient for enhancing a sex life.”

Explore intimacy and your ‘new normal’

While not everyone will be interested in therapy after receiving a surprising medical diagnosis or adjusting to life with a disability, finding a therapist who understands your needs could make all the difference.

“I always call therapy the safe container,” says Phillips, who hosts the Sex & Chronic Illness podcast.

“It is the place where people who are chronically ill feel safe and it is a place where they are not judged. It is the place where they can learn the skills in using their voice. This helps them become more aware and assertive in expressing their sexuality.”

If you’ve recently received a diagnosis, then it’s possible you’re feeling shell-shocked and lacking in confidence.

This is why considering therapy and finding a specialized therapist could be particularly helpful, especially if you’re dealing with relationships, intimacy, and sex.

“We have to realize that when so much changes in a person or a couple’s life due to chronic illness, a satisfying sex life can be one way to feel healthy and normal,” says Phillips.

Get creative

Whether you’ve always hoped to explore your sexuality in more depth, or you’re looking to spice things up post-diagnosis, it’s always possible to create more fun, excitement, and surprises in your sex life.

“When living with a chronic illness, sex can be a powerful source for comfort, pleasure, and intimacy,” Phillips says. “Therefore, I always say that you have to get curious about your partner and get creative with your sex. People start to look at this as a new sexual adventure because so much has changed due to chronic illness.”

If, like me, your physical sensations have changed with your chronic illness, you might need to try new positions and techniques to achieve orgasm or feel good during sex.

If you can, try viewing this as a positive thing rather than a burden and an opportunity to create greater intimacy with a partner.

Depending on your illness or disability, you may not be able to restore sensation to certain part of your body. That doesn’t mean pleasure isn’t possible.

“Focus should be on stimulation to the chosen area without any plans of moving to any other areas or having sexual intercourse,” says Phillips. “These exercises place the emphasis on intimacy and pleasure over the goal of performance and orgasm.”

If your body has changed because of a chronic condition or disability, then using toys or props might help. (If you have regularly bemoaned the lack of fully accessible sex toys, a new company, Handi, might soon have the answer.)

Don’t give up if you don’t want to

Perhaps the most important thing to remember is that the choice of whether to have a sex life is yours and yours alone.

Whether you’re working on your orgasm solo (like I needed to do), or you’re embracing sexual intimacy with another person, your sex life is yours.

It shouldn’t be halted because of bad advice, embarrassed doctors, or a lack of knowledge.

Complete Article HERE!

You’ve Survived Cancer

— Now What About Dating?

Don’t let body image concerns and emotional changes stop you from seeking love

by Susan Moeller

Six years ago, Deanna Savage had breast cancer, followed by a double mastectomy and reconstruction. After more than a year of surgeries and treatment, she returned to online dating.

But her body felt different than in past years of dating: She had new “pucks and dents” in places and lost sensitivity in some areas. And she had something extra accompanying her on dates: her cancer diagnosis.

“I either mentioned it right away or I didn’t mention it for a while,” says Savage, 52, who works for a wine distributor in Milwaukee and founded a nonprofit breast cancer support organization, Savage Support. “Both ways scare people off because everyone has their own relationship or even explanation of what cancer is.… And so they projected that onto me.”

Cancer and its treatments affect not only the look of patients’ bodies but also sensation, mechanics and stamina, says experts like Savage, who is also a mentor with ABCD, or After Breast Cancer Diagnosis, a Milwaukee one-on-one mentoring organization. Yet companionship, romance and intimacy foster healing, says Yanette Tactuk, a licensed clinical social worker with Memorial Sloan Kettering Cancer Center in New York City.

Resources for Dating After Cancer

Here are some places that help with navigating dating and sex in the face of a cancer diagnosis.

• Check with your local cancer center. Many now have survivorship clinics that address issues of wellness and lifestyle, including relationships and sexuality.

• Ask your health care provider or chapter of the American Cancer Society about in-person or online support groups.

• Look for peer mentoring programs at cancer centers or organizations such as ABCD (After Breast Cancer Diagnosis) to connect you one-on-one with someone who has had a similar experience.

• Consider reputable online sources such as Cancer.net, sponsored by the American Society of Clinical Oncologists, which has information on dating and sexuality.

• Find a therapist or certified sex educator. The American Association of Sexuality Educators, Counselors and Therapists has a searchable online directory.

“It’s important to feel comfortable and confident, regardless of where you are in your treatment process and regardless of your relationship status,” Tactuk says. “The advantages of finding ways to love and accept oneself and to connect with others are physical, psychological, emotional and relational.”

Dating after cancer

If you’re ready to start dating, begin by thinking about why, says Jeffrey Gaudet, a licensed clinical social worker in Mashpee, Massachusetts, who has led cancer survivorship programs. Dating could include physical intimacy or not, he says.

“Understand your body, but also understand where you’re coming from emotionally,” he says. “Someone might be looking for a fully developed relationship that might lead to marriage, or they might be saying, ‘Hey, you know what, I just need someone to be with me.’”

Consider issues you’ve had with dating in the past, he says, such as how you communicate or feelings about your body. If you are ready for intimacy, don’t be shy about gathering information on how to make it work. As cancer patients live longer, more resources are available to improve the quality of their lives, including sexually. Don’t worry that you’re the only one who has a body that’s not looking or working quite as it used to.

“This is a really common experience,” says Don Dizon, M.D., professor of medicine at Brown University and founder of the Sexual Health First Responders Program in Providence, Rhode Island. “If you look at survey data, those who report some degree of sexual compromise is anywhere between 50 and 90 percent.”

Physicians and patients rarely discuss relationships or sex because cancer checkups are so focused on survival or treatment plans, Dizon says. Patients may be too distracted or embarrassed to ask questions, or think they are alone in having issues. A survey by the health organization Livestrong found that fewer than half of patients bring up these issues, he says.

“It’s really not until people leave that room that they start thinking, Boy, I really wanted to ask those other questions,” Dizon says. “We, as clinicians, assume things that are important will be brought to our attention by patients themselves, [but] when it comes to sexual health, that’s not going to happen.”

Discussing cancer and sexuality

For starters, he says, understand who you are as a sexual being. What’s your perspective on dating and sex? How do you respond to relationship cues? Are you able to communicate with a partner? Are you one to jump right into a relationship or expose your inner life slowly?

And be flexible about what intimacy might look like, Dizon says.

“What we’re learning is that couples can … find their own ways to experience pleasure and experience satisfaction,” he says.

Ellen Barnard, a social worker and certified sex educator who co-owns; A Woman’s Touch in Madison, Wisconsin, a sex education resource center and sexual health products shop, describes herself as a “problem solver.” One reason she and co-owner Myrtle Wilhite, M.D., started the shop 25 years ago was to help breast cancer patients find ways to improve sexual response without hormone replacement therapy.

Their website has a downloadable resource sheet on “Healthy Sexuality After Cancer,” as well as a place to submit questions. These days, Barnard and Wilhite work with customers with all kinds of cancers and also train health care providers.

“There’s plenty that can be done.… Nobody needs to lose their enjoyment of sexual pleasure,” Barnard says.

And remember, it’s unlikely that anyone over 50 will have a body that works perfectly.

“The most important thing that I try to instill in people is not to see themselves as ‘damaged,’” Dizon says. “Getting older comes with its own complications, but cancer’s not the only complication people will be bringing to the table.”

Complete Article HERE!

Sex After Cancer

— The Topic No One Wants to Talk About

By

I was clueless when I was diagnosed with breast cancer. The fear of the unknown was overwhelming. I had so many questions but didn’t have any answers. I did however find a group of breast cancer survivors through Facebook and quickly joined.

The post pinned at the top of the group’s page said that all questions were accepted, and the administrator of the group posted that no topic was off limits and that all posts would be kept confidential.

As someone who had many questions with very little answers, I quickly decided to join the group.

I perused the page for several months and quickly became “virtual friends” with some of the women. The ladies in the group became a wonderful resource. They were gracious and kind when I’d ask a question.

But one topic seemed off limits and it was one I really wanted to discuss — sex. At first, I was afraid to bring it up. Although I assumed that I wouldn’t be openly judged, it felt odd to discuss such a sensitive topic with complete strangers. But as I’d scroll through daily posts, I found I wasn’t the only one interested in post-cancer intimacy. There seemed to be others who needed answers.

Everything I’d read indicated people didn’t openly talk about their sex lives, at least those with severe health issues didn’t. But I found, after cancer treatment, many would admit, the physical relationship with their spouse had changed. What once had been a spontaneous and natural relationship had become uncomfortable and difficult. And, many who’d admitted their struggles chose to deal with it alone instead of trying to find help because they were embarrassed to do so.

I was thankful when the topic of sex gained popularity in the Facebook group. The administrator posted questions and wanted the members to share their thoughts. According to the responses, the reasons many were struggling in their sexual relationships was due to physical pain. The second opinion in the poll indicated emotional distress to be a huge factor. Some women posted comments regarding mastectomy. They indicated losing one or both breasts greatly affected their self-esteem and negatively impacted their desire for sexual intimacy. I was surprised at their candor.

What I discovered, through the online poll, was that some women found talking about post-cancer sex easy, but for others, including myself, it was a challenge. And I wondered why that was the case.

I’d always been raised to believe sex was supposed to be a wonderful part of marriage. It was designed to bring fulfillment to both members of a relationship. While I understood health challenges could certainly affect that area of a person’s life, I wondered why those who’d faced cancer-related intimacy issues didn’t want to share.

When the editors of CURE® recently suggested some relevant topics for VOICES contributor submissions, I looked through the short list. I’m always looking for something new and interesting to write about. One topic on that list grabbed my attention but frightened me at the same time — sex.

At first, I didn’t want to write about sex. But the more I thought about it, the more I felt like I needed to do it. From day one, I have always tried to be open and honest about my breast cancer journey. And, I have always felt it was important to share all aspects of my journey in hopes that something I share might help others. So, I pulled up my big girl panties and made the commitment. I would broach the subject as best I could.

It was many months after my treatment ended before my husband and I decided to become intimate. I’d felt self-conscious and wanted to wait. My husband was patient and understanding but when the time felt right, we decided to try.

That evening, we scheduled a time where we could relax and enjoy being together without distractions or interruptions. Neither of us had expectations. We were in uncharted territory. What we did know was we loved each other and wanted to be together.

Since losing my breasts, I hadn’t felt very feminine, so I decided to put on some lingerie in hopes of hiding my chest.

The evening began with gentle caresses and tender touches. As we shared our love, I noticed areas of sensitivity and discomfort. Whenever a touch was uncomfortable, I’d whisper in my husband’s ear and he’d focus on another area.

As we continued to reconnect, I realized I’d lost all feeling in my chest. The nerves had been severed during surgery and my torso was completely numb. I realized, what once had been a source of pleasure was no longer.

To protect our privacy, I won’t share the remainder of the details from that evening but suffice to say, we quickly learned to change and adapt to many of the challenges breast cancer brought our way.

I did some digging as I wanted to learn more about post-cancer intimacy and the issues many men and women face. I found there are many books on the subject.

A consensus, included in the information that I read, indicated that feeling anxious or uncomfortable toward sex after surgery or treatment was completely normal, especially for those who hadn’t been intimate in some time. I was glad to learn that! Continuing to read, I gathered valuable information which included important things to remember like:

  1. Don’t attempt a physical relationship until you are ready;
  2. Talk to your mate about your feelings;
  3. Be willing to adapt and try new things, and
  4. Consult a sex therapist if necessary.

According to breastcancer.org, “The most uncomfortable stuff to talk about is probably your sex life and the changes that have taken place with your illness. You may not know what needs fixing or how to fix it, but you know things are different.”

Many women report having less sex than before their illness, for several reasons:

  • The breast cancer experience slows down your body. It takes longer to do lots of things, including getting interested in, as well as starting and finishing, sexual intercourse.
  • Sex may be uncomfortable or even painful if you’ve been thrown into sudden-onset menopause. No surprise that you tend to have less sex, for now. Many women may have had little or no sex from the time of diagnosis through treatment.

Most people have wild ideas about what goes on in other people’s bedrooms. Give yourself a break: The carefully researched book Sex in America (by Michael, Gagnon, Laumann, and Kolata) tells us that Americans have a lot less sex than the movies, television, and the guys in the locker room would have you believe. The averages reported in that book are:

  1. seven times a month between ages 30 and 40;
  2. six times a month between ages 40 and 50, and
  3. five times a month between ages 50 and 60.

For people over 60, the numbers continue to decline. But although you may assume that no one in their 70s and 80s has a sex life, that’s just not so, the authors wrote.

Whew! It helped a lot to understand everyone’s sex life is very different and there’s no gold standard for what should or shouldn’t happen, especially post cancer. And, experts agreed, even if sexual activity has decreased or even stopped, it was OK. There were still ways to maintain closeness with a partner. Sex did not need to be the focus. Some survivors found contentment in holding hands, cuddling, hugging, and kissing.

My husband and I discovered, as we took the pressure off our relationship, by removing the sex equation, we had freedom to reconnect in ways we never imagined. It has taken time and it hasn’t always been easy, but we’ve managed to rekindle that precious part of our lives.

Discussing the topic of post-cancer sex can be challenging, but there are many good resources available. Some of the ones we found most helpful include:

Breast Cancer Husband: How to Help Your Wife (And Yourself) During Diagnosis, Treatment, and Beyond

Sex and Cancer: Intimacy, Romance, and Love after Diagnosis and Treatment

Sex and Cancer: Six Weeks to Better Sex for Couples During and after Cancer Treatment

The Breast Cancer Survival Manual, Sixth Edition: A Step-by-Step Guide for Women with Newly Diagnosed Breast Cancer

Dr. Susan Love’s Breast Book

Complete Article HERE!

Sexual health during cancer treatment

Many patients don’t want to talk about sexual health while being treated for cancer — here’s why they should.

Changes in sexual health may not be top of mind when you’ve been diagnosed with cancer, but it might be more important than you expect. It’s important to talk to your health care providers about sexual health and cancer.

By: Sara Thompson

Cancer treatment and sexual health

Depending on the treatment you are given, sexual side effects range from mildly annoying to downright debilitating. For instance, hormone-blocking medications can cause vaginal dryness, which can lead to painful sex or lowered sex drive. Patients who have mastectomy (breast removal) may no longer have feeling in the chest area. Changes in body image affect sexual well-being. Young women may face infertility or early menopause with cancer treatments.

“This topic isn’t discussed enough,” said Laila S. Agrawal, M.D., medical oncologist with Norton Cancer Institute. “But sexual health affects your quality of life, and there are ways to address those issues.”

You’re not alone

Patients tend to feel their cancer diagnosis sets them apart from others. They may feel like their issues are theirs alone, but they’re not.

“Sexual health concerns are common issues for cancer survivors,” Dr. Agrawal said. “A Livestrong survey in 2010 listed this as the third most important issue for cancer survivors.”

Many times, patients also feel they shouldn’t discuss their sexual issues with their doctor. Patients may feel uncomfortable asking, or they may be afraid to make their doctors uncomfortable. They may believe sexual health issues are not as “important” as their physical cancer treatments and therefore may be reluctant to bring it up with the doctor.

Practical tips for today

Dr. Agrawal has some ideas to help you open the lines of communication with your doctor, care team and partner.

“It is understandable that this may a sensitive topic to discuss with your doctor,” she said. “Just know that this is a very common issue among cancer survivors, and medical treatments are available that may help.”

It may help to write down your questions before you see your doctor. Here are some questions to get you started.

  • Is there a risk of infertility with this treatment? What can I do about it?
  • Is it safe to have sex while I am going through chemotherapy? What precautions do we need to take?
  • Is it possible to get pregnant while on this treatment? Would there be any increased risks or negative effects on the baby?
  • What method to prevent pregnancy would be right for me?
  • Will this treatment have effects on sexual function?
  • Can anything be done about low interest in sex?
  • Can anything be done to help with my body image?
  • Sex has become painful. Is there anything that can help?
  • What is pelvic floor physical therapy, and would it be helpful for me?

Further resources

“In the near future, we hope to open a sexual health clinic at Norton Healthcare for a more comprehensive assessment and treatment program,” Dr. Agrawal said. “The behavioral oncology program can assist with issues that affect sexual functioning, including body image, libido, depression, anxiety and relationship concerns. Some conditions must be checked and treated by a gynecologist.”

Many sexual health concerns after cancer are very common and can be treated. Just like many things are not the same after a cancer diagnosis, your sex life may not be the same either. Having patience with yourself, having honest communication with your partner and looking at intimacy in new and creative ways can help restore a healthy sex life.

Complete Article HERE!

How to find body positivity after cancer

Cancer can change how you feel about you, your body and your sexuality.

By Good Housekeeping

Cancer changes everything. The diagnosis, the treatment and the aftermath can affect your work, your finances, your relationships and, even more fundamentally, how you think and feel about you, your body, your sexuality.

The impact of treatment for breast and gynaecological cancers can be far reaching. Sometimes the changes are very visible, such as a mastectomy, while chemotherapy, radiotherapy or a hysterectomy can cause other issues, including infertility, early menopause, fatigue, loss of libido and physical changes like narrowing and shortening of the vagina, vaginal dryness and painful sex.

Changes to your body and the way you feel about it can come as a shock post treatment, says clinical psychologist Dr Frances Goodhart. “Treatment can be gruelling and often your sole focus is on getting through it. When it’s over and you’re living with a changed body, worrying about cancer coming back and feeling as though you’ve lost part of yourself, you can struggle with the sense of who you are.”

You don’t have to love your body but it is important to be able to accept.

If you find yourself struggling, you are certainly not alone. Research by Target Ovarian Cancer in 2016 found that 69% of women with ovarian cancer suffered a loss of self esteem, 73% had difficulty with intimacy and 84% reported a lower sex drive. Similarly Breast Cancer Care researchers found that eight in 10 women were unhappy with their sex life after treatment and research by Jo’s Cervical Cancer Trust found that 67% of women experienced changes to their sex lives.

Given these statistics it’s clear that at least for some women, learning to love your body post cancer can be a very big ask. “Let’s be realistic – how many women actually love their bodies pre-cancer?” says Dr Goodhart. “So you don’t have to love your body but it is important to be able to accept it and recognise what it has brought you through.”

Read on for advice for finding that acceptance…

Try not to put off looking at your scars

If you have scars or other visible changes to your body, try not to put off looking at them with your doctor or nurse if this helps. Take it gradually – it’s normal to feel shocked and upset at first but for most women these feelings will ease over time.

Ask for help if you need it

And do it as soon as possible. Jo’s Trust found that two thirds of the women who experienced changes to their sex life didn’t tell a doctor. Your GP or clinical nurse specialist can provide practical help with issues such as vaginal dryness, tightness and pain and give you information on how to cope with sexual difficulties or put you in touch with someone who can help.

Intimacy doesn’t have to mean intercourse

Holding hands, cuddling, kissing, stroking can all help you to slowly get back to feeling closer and rebuild your confidence in taking things to the next level, or not. Remember it’s ok to not want to be sexual – it’s only a problem if it’s causing a problem.

Keep talking to your partner

What you have been through is scary for both of you and communication can break down if both of you avoid saying how you really feel to try to protect the other from hurt.

If you are single and want to meet someone, take your time

Dating can be hard and you are likely to feel frightened of rejection. It can be hard to know when to share the information about your cancer with a new partner – while there is no simple answer it’s important to reach a stage where you feel as though can you trust your new partner, especially if you have body changes that they don’t know about. Honesty is key to successful relationships and a loving partner should accept you as you are.

Allow yourself to grieve

You have experienced major changes to your body and a loss of confidence and certainty and it’s quite normal to feel sad, angry, defiant, even disbelieving about what has happened.

Express yourself

Talking to your partner, to a friend, to a counsellor or to other women who have been through it can help you to process what has happened and find your way forward. Some people find that writing a journal where you allow yourself to write exactly what you feel, or starting a blog.

Exercise can help boost your mood and your body confidence

One study found that twice weekly strength training after cancer helped improve women’s body image and feel better about their appearance, health, physical strength, sexuality, relationships and social functioning.

Find the positives

Despite the challenges, many women find that they emerge from treatment with a new found respect for their body. “It certainly takes time to rebuild confidence in your body but many women say that they start to reassess and to realise what their body is capable of. Women say to us if I can get beyond this I can tackle anything head on,” says Lizzy Rodgers, head of supportive services at Target Ovarian Cancer.

Complete Article HERE!

Saying sex increases cancer risk is neither totally correct, nor in any way helpful

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A study published recently claims to have found a link between having had ten or more sexual partners and an increased risk of cancer. But it’s not as simple as that.

While having a sexually transmissible infection (STI) can increase the risk of certain types of cancer, using a person’s lifetime number of sexual partners as a marker of their likely sexual health history is one of several flaws in this research.

The evidence from this study isn’t strong enough to conclude that having had multiple sexual partners increases a person’s risk of cancer.

Misinterpreting these findings could lead to stigma around STIs and having multiple sexual partners.

What the study did

The research, published in the journal BMJ Sexual & Reproductive Health, used data from 2,537 men and 3,185 women participating in the English Longitudinal Study of Ageing, a nationally representative study of adults aged 50+ in England.

The average age of participants was 64. Most were married or living with a partner, white, non-smokers, drank alcohol regularly, and were at least moderately active once a week or more.

Participants were asked to recall the number of people with whom they had ever had vaginal, oral or anal sex in their lifetime. The researchers grouped the responses into four categories shown in the table below.

The researchers then examined associations between lifetime number of sexual partners and self-reported health outcomes (self-rated health, limiting longstanding illness, cancer, heart disease and stroke).

The researchers controlled for a range of demographic factors (age, ethnicity, partnership status, and socioeconomic status) as well as health-related factors (smoking status, frequency of alcohol intake, physical activity, and depressive symptoms).

What the study found

Men with 2-4 partners and 10+ partners were more likely to have been diagnosed with cancer, compared to men with 0-1 partners. There was no difference between men with 0-1 partners and 5-9 partners.

Compared to women with 0-1 partners, women with 10+ partners were more likely to have been diagnosed with cancer.

Women with 5-9 partners and 10+ partners were also more likely to report a “limiting longstanding illness” than those with 0-1 partners.

The authors don’t specify what constitutes a limiting longstanding illness, but looking at the questions they asked participants, we can ascertain it’s a chronic condition that disrupts daily activities. It’s likely these ranged from mildly irritating to debilitating.

There was no association between number of sexual partners and self-rated general health, heart disease or stroke for either men or women.

Notably, while statistically significant, the effect size of all these associations was modest.

What does number of sexual partners have to do with cancer risk?

There is a reason for investigating whether a person’s lifetime number of sexual partners has anything to do with their cancer risk. If you’ve had a lot of sexual partners, it’s more likely you’ve been exposed to an STI. Having an STI can increase your risk of several types of cancer.

For example, human papillomavirus (HPV) is responsible for 30% of all cancers caused by infectious agents (bacteria, viruses or parasites), contributing to cervical cancer, penile cancer, and cancers of the mouth, throat and anus.

Viral hepatitis can be transmitted through sex, and having chronic hepatitis B or C increases the risk of liver cancer.

Untreated HIV increases the risk of cancers such as lymphomas, sarcomas and cervical cancer.

How can we make sense of this?

The authors of the study acknowledge the numerous limitations of the analysis and recommend further work be done to confirm their findings. We must interpret their results with this in mind.

Their use of lifetime number of sexual partners as a proxy measure for STI history is a key problem. While there is an association between having a higher number of partners and an increased risk of STIs, many other factors may be important in determining a person’s risk of being infected with an STI.

These include whether they’ve practised safe sex, what type of infection they might have encountered, and whether they’ve been vaccinated against, or treated for, particular infections.

Further, the analysis was based on cross-sectional data – a snapshot that doesn’t account for changes over time. Participants were asked to recall information from the past, rather than having measurements taken directly at different time points. It’s not possible to establish causation from a cross-sectional analysis.

Even if the association is confirmed in prospective, longitudinal studies, the findings may not apply to other groups of people.

Recent advances in vaccine development (such as the wide availability of the HPV vaccine), better STI prevention (such as the use of pre- and post-exposure prophylaxis – PreP and PEP – for HIV) and more effective therapy (for example, direct-acting antiviral agents to treat hepatitis C) will reduce the impact of STIs on cancer risk for those who can access them.

People with higher numbers of sexual partners were more likely to smoke and drink frequently (increasing the risk of cancer), but also to do more vigorous physical activity (decreasing the risk of cancer).

For women, a higher number of sexual partners was associated with white ethnicity; for men, with a greater number of depressive symptoms. Although the researchers controlled for these factors, these points highlight some inconsistencies in the pattern of results.

The researchers also couldn’t explain why a greater number of sexual partners was associated with a higher likelihood of a limiting chronic condition for women, but not for men.

Ultimately, this study raises more questions than it answers. We need further research before we can use these results to inform policy or improve practice.

The paper concludes by saying enquiring about lifetime sexual partners could be helpful when screening for cancer risk. This is a very long stretch based on the evidence presented.

This approach could also be harmful. It could invade privacy and increase stigma about having multiple sexual partners or having an STI.

We know experiencing stigma can discourage people from attending sexual health screenings and other services.

It would be better to put limited health resources towards improving prevention, screening and treatments for STIs.

Complete Article HERE!

“Having cancer changed my sex life irreversibly”

“Our sex life, which had kept us so close in the past, changed irreversibly”

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Meredith, 27, was diagnosed with cancer twice in her twenties (first cervical cancer and then breast cancer). She explains how it impacted her relationship and sex life, and how it changed the way she feels about intimacy.<

There’s never a good time to be diagnosed with cancer, but it really felt like the bombshell hit me at the worst possible moment. In December 2016, I was about to start training for my dream career, had just moved house and was excited about the future, when a routine smear test revealed I had cervical cancer. It was a total shock as I’d had no symptoms. The world spun on its axis.

Before that day, I was the same as many twenty something women: I loved going to the gym, dressing up for nights out with friends and going to football matches with my boyfriend Gareth, a man whose zest for life drew me in from the moment we met at a student event in a pub.

When Gareth and I first got together our relationship was long distance. Which meant that whenever we met, we’d be so excited to see one another that sex happened naturally – being physical was fun, easy and a glue that bonded us. But all that changed once I began my treatment.

Before that day, I was the same as many twenty something women: I loved going to the gym, dressing up for nights out with friends and going to football matches with my boyfriend Gareth, a man whose zest for life drew me in from the moment we met at a student event in a pub.

When Gareth and I first got together our relationship was long distance. Which meant that whenever we met, we’d be so excited to see one another that sex happened naturally – being physical was fun, easy and a glue that bonded us. But all that changed once I began my treatment.

Sex slipped further down the list of my priorities, especially during chemotherapy. After one session I was so unwell, I pushed Gareth away when he tried to comfort me. My rejecting him was difficult for us both to understand, but drugs affect your moods and thoughts, and I’d gone into crisis mode. All my energy went on trying to survive.

Our sex life, which had kept us so close in the past, had changed irreversibly. I know Gareth found it frustrating at times and we both worried our relationship might not survive, but all we could do was acknowledge the situation was awful and push through anyway, hoping we’d be happier on the other side.

When you know the medical professionals you interact with are trying to save your life, asking for advice about what you can and can’t do in the bedroom feels trivial (although whenever I did ask, they were helpful – one for example, prescribed me a moisturiser to help deal with vaginal dryness, a chemo side effect).

Slowly, we learnt new ways to be intimate with one another, like talking truly openly about how we’re feeling and about how my body has changed. We attended talks about sex and relationships through Breast Cancer Care and Jo’s Trust, which helped, especially realising others were in a similar boat. Practical things like taking it slow, longer foreplay and using lots of lube help too. I’ve also cleared out all of my old bras and replaced them with new sets – my old underwear had negative associations, so this was another small way of me reclaiming back part of my confidence.

I’ve now been given the all clear and am back to work pretty much full-time, bar the odd day off for a check-up appointment. Some mornings, I look in the mirror and find the scar on my breast empowering, on others it gets me down – although Gareth tells me I look amazing regardless. Communication is key in any relationship, but my experience has really hammered that home. I’ve learned that intimacy isn’t just about sex but about the emotional connection between two people.

Complete Article HERE!

How to Reignite Your Sex Life After Going Through Cancer

Your body will feel different. These tips can help.

By

After cancer, bodies and relationships change. In fact, many men find their sex lives look and feel different from their pre-cancer days. Although you may feel embarrassed or nervous to open up to your partner about sexual changes, talking about post-cancer intimacy can help you re-envision your body and your relationship. These tips can help pave the way for establishing a new sex life after a cancer diagnosis and treatment.

Start talking early

Although it seems like physical contact is one of the most important parts of intimacy, the truth is that communication is essential for establishing and igniting closeness. Remember, there’s no one way affection should look, and previous relationship expectations can be difficult to maintain during cancer recovery.

For men in particular, sexual function changes can manifest as shifts in desire, the impacted ability to get or maintain an erection, or even delayed or dry ejaculation. Instead of withdrawing and avoiding intimacy or affection, I advise my patients at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) to talk with their partner right when they’re diagnosed to start the dialogue about possible changes in your sex life. Before you go into surgery or start therapy, have a conversation about your sexual self-esteem and identity as a sexual person. You and your partner can check in with each other a few months later to see how you’re both feeling about your sexual self-identity and work on identifying a new vision of intimacy in your relationship.

And it’s not just your partner you should be talking to—communication is equally important between you and your doctor. Going through cancer can change your sex life, but that doesn’t mean your doctor has covered all the sexual function differences you may notice. If you notice sexual functioning changes, talking with your doctor can open up the possibilities of personalized treatment options. By speaking up and asking questions, you can better establish a healthy approach to reclaiming your sexual identity.

“Date” your partner again

Partnership is a key part of any relationship, and should be just as important after diagnosis. During cancer, relationships can transition from partner/partner to patient/caregiver, and returning to old “norms” can be challenging. A good way to approach this is to continue to date your partner throughout treatment. By dreaming together or going out to eat, you can help refocus your relationship around things that aren’t related to cancer. You can also try scheduling time for intimacy and affection, which can help rekindle intimacy found in partnership. Try to take your time and get to know each other again.

Redefine intimacy

After treatment, sexual desire can wane. A lot of things can impact desire including hormonal changes, pre-occupation/focus changes, decreased self-esteem/confidence, and mental health issues (e.g., anxiety or depression). Remember, intimacy might not happen spontaneously and might not involve sex at all. Try playing to other strengths and learning to perfect new types of intimacy—not every sexual interaction requires an erection or an orgasm. If your goal is satisfaction, it’s important to note that men can still reach orgasm without an erection and the penis itself can still experience sensation. There are many ways to feel pleasure, these just might not look the exact same as they did before diagnosis. Remember you’re in charge of defining what you want intimacy to be—it can even be as simple as connection.

The sexual side effects that you may experience from cancer can happen to anyone—cancer treatment just speeds up the process. Normalizing and understanding issues of intimacy after cancer is just one step you can take to acknowledge habits or preconceptions that may be harmful. Sex doesn’t have to be a certain way to be fun and exciting. With these guidelines, you can work on re-establishing intimacy and gaining newfound confidence post-cancer.

Complete Article HERE!

For survivors, breast cancer can threaten another part of their lives: sexual intimacy

By Barbara Sadick

Jill was just 39 in July 2010 when she was diagnosed with stage 2 breast cancer. Her longtime boyfriend had felt a lump in her right breast. Two weeks later, she had a mastectomy and began chemotherapy. The shock, stress, fatigue and treatment took its toll on the relationship, and her boyfriend left.

“That’s when I began to realize that breast cancer was not only threatening my life, but would affect me physically, emotionally and sexually going forward,” said Jill, a library specialist in Denver who asked that her last name not be used to protect her privacy.

When someone gets a breast cancer diagnosis, intimacy and sexuality usually take a back seat to treatment and survival and often are ignored entirely, said Catherine Alfano, vice president of survivorship at the American Cancer Society. Doctors often don’t talk with their patients about what to expect sexually during and after treatment, and patients can be hesitant to bring up these issues, she said.

Among the common problems that the cancer treatment can cause are decreased sex drive, arousal issues and pain when having sex, and body image issues (if there has been such surgery as a mastectomy), Alfano said. Many of these problems are treatable, but only if a patient speaks up. That way, the clinician can refer the person to specialists versed in physical or psychological therapy for cancer survivors or health specialists familiar with the useful medications and creams.

According to the National Cancer Institute, about 15.5 million cancer survivors live in the United States. Of those, 3.5 million had breast cancer.

Sharon Bober, a Dana-Farber Cancer Institute psychologist and sex therapist, said the biggest problems couples and single women face after breast cancer are the surprises that unfold sexually. She said chemotherapy and hormone suppression therapy can send women abruptly into menopause or exacerbate previous menopausal symptoms, such as vaginal dryness, pain with intercourse and stinging, burning and irritation. Many women are also surprised to discover that breasts reconstructed after a mastectomy have no sensation.

Betty and Willem Bezemer. Betty, 72, had been diagnosed with breast cancer at age 50. Throughout her treatment, her husband kept her spirits up. The couple maintained their intimacy by continuing their habits together, such as dancing and soaking in bubble baths.
Couples, Bober said, often can benefit from working with a sex therapist trained in breast cancer issues. “It takes time and practice, especially in the face of permanent changes such as loss of sensation or body alterations,” she said. “Women need to become comfortable in their bodies again.”

Amber Lukaart, 35, was diagnosed in 2016 with invasive ductal carcinoma in her right breast. She had no family history of the disease and found the lump herself. She had been working at the Center for Women’s Sexual Health in Grand Rapids, Mich., helping survivors navigate their sexual issues — work that turned out to help her, too.

Her treatment was 16 rounds of chemotherapy, a partial mastectomy of her right breast, 20 rounds of radiation that left the skin on her chest raw and inflamed, and six months of a hormone blocker to protect her ovaries so she could have children in the future.

These treatments affected her sexuality and marriage. The first time she and her husband had sex after the treatments was horribly painful because of dryness. The pain, plus fear of cancer recurrence and death, put a halt to their attempt to reconnect emotionally. At the same time, the partial mastectomy and radiation left her breast looking malformed. She said she felt self-conscious and uncomfortable about it.

She turned to people she knew from her work and felt lucky to have the support.

“I understood immediately that I was in a unique position to help myself and my husband understand and communicate to each other the questions and concerns we both had about our sexual relationship,” Lukaart said.

Yet even with access to sex therapists, sex counselors and treatments, Lukaart said she still felt frustrated with the relative lack of data regarding hormone use for someone like her with estrogen-receptor-positive breast cancer — which about 80 percent of all breast cancer patients have, according to the National Cancer Institute. This type of the disease causes cancer cells to grow in response to the hormones estrogen and progesterone. Hormone treatments that are standard for dryness usually cannot be used after this time of cancer. And over-the-counter remedies didn’t seem to help Lukaart.

She and the co-founder of the women’s center, Nisha McKenzie, researched nonhormonal options. They came across a laser therapy that increases the thickness and elasticity of the vaginal walls. It took three sessions but eventually Lukaart said it gave her back the ability to have a sexual relationship with her husband. Three treatments cost about $3,000 and are not covered by insurance. (Lukaart’s work at the center, which now provides laser treatment, allowed her to get the therapy for free.).

McKenzie and Lukaart are focusing their efforts to help survivors recognize that they may need to do more than just ask their doctors for advice if they want to find ways to get their lives back on track sexually.

McKenzie said several organizations can provide the names of experts who can help, including the American Association of Sexuality Educators, Counselors and Therapists and the International Society for the Study of Women’s Sexual Health.

“Women need to know,” said Lukaart, “that they have to advocate for themselves and that it’s okay to want more than just to survive cancer — it’s ok to thrive, too.”

In Jill’s case, after exhausting the help of her oncologist and other physicians, she joined a clinical study run by Kristen Carpenter, director of Women’s Behavioral Health at Ohio State University, that looks at ways of improving sexual and emotional health after breast cancer.

The study of 30 women used mind-body techniques, such as progressive muscle relaxation to help with sexual intimacy, Kegel exercises to improve pelvic floor muscle tone and cognitive behavioral therapy to help them rethink negative, self-directed thoughts.

The group also had discussions about assertiveness training, communication techniques to use with partners, sexual positions, and aids that may improve comfort and pleasure.

“We laughed, cried and learned from each other’s struggles and stresses in a warm and understanding environment,” Jill said. “and it helped give me the tools for communicating my needs and challenges and to be aware that psychological and physiological interventions are available.”

A supportive partner can ease the problems of breast cancer survivors.

Betty Bezemer, 72, had been diagnosed with breast cancer at age 50. Throughout her treatment, her husband kept her spirits up. The couple maintained their intimacy by not only discussing what was happening but also continuing their habits together, such as dancing and soaking in bubble baths.

Bezemer said their relationship never suffered. And, with the help of lubricants and other remedies, they found ways to be closer sexually and otherwise.

“My husband always made me feel that he had fallen in love with my head and heart and not just my breasts,” said Bezemer, who now serves on the Houston board of the breast cancer organization Susan G. Komen.

“Obstacles may not be easy to overcome, but women need to understand and accept that problems of intimacy and sex will often follow breast cancer treatment,” said Julie Salinger, a clinical social worker at Dana Farber. “But there are solutions, and the sooner people start to ask about them, the better, as they will only get worse by waiting.”

Complete Article HERE!