Gynecologic cancer develops in the female reproductive system, including the external and internal sex organs. Treatment for gynecologic cancer often involves surgery, chemotherapy, and radiation therapy. Each type of treatment can affect many aspects of your life, including your sexuality, how you feel about your body, and how your body responds to sex.
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Your sexual health may be impacted by gynecologic cancer treatment. Know that there are ways to manage these changes and experience a satisfying sex life.
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Getting to know your body and feeling good about yourself are important steps in healing and regaining your sexual confidence.
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Be compassionate to yourself, a good communicator, creative, and patient as you rediscover your sexuality after cancer treatment. Also, consider getting professional help.
Lack of sexuality and intimacy in people with gynecologic cancer is common. It’s often due to the organs affected by cancer and the side effects of treatment. But you can improve your sex life by using coping strategies.
Physical impacts of gynecologic cancer treatment on sexual health
Hysterectomy is a common surgery for gynecologic cancer. If your ovaries are removed (oophorectomy) during this procedure, and you had not already gone through menopause, you can experience symptoms of menopause – this is known as surgical menopause.
Among others, vaginal dryness is a well-known side effect of menopause that can lead to painful sex. After a hysterectomy, you may also experience organ prolapse, which may make having sex uncomfortable. Your libido may also be diminished due to decreased hormones after a hysterectomy.
If you need a vulvectomy (removal of all or part of the external female genitalia), your outer genitals will look and feel different. A vulvectomy may affect your self-esteem and how your body responds to sex. Other surgeries for gynecologic cancer may involve shortening or narrowing the vagina, which may change your ability to enjoy sex.
In the case of advanced cancer or cancer that comes back, you may need to undergo more extensive surgery like a pelvic exenteration. After this procedure, you may often have a colostomy or ileostomy, which may change your body image.
Chemotherapy may cause unpleasant side effects that may impact your sexuality. These include fatigue, lack of interest in having sex, and menopausal symptoms resulting in vaginal dryness. You may also experience side effects like hair or weight loss that can change how you feel about your body.
Sometimes, radiation therapy is needed to treat certain gynecologic cancers. Depending on the area treated, this treatment can affect your sexual function by causing fatigue, tenderness, and scarring in the vagina.
Emotional impacts of gynecologic cancer treatment on sexual health
You may be self-conscious about the physical changes that have occurred due to cancer treatment. You may also feel sad or depressed. Body image issues from scarring, hair loss, and weight changes may add to these emotions.
You and your partner may feel nervous about having sex and unsure about what sex will feel like. Loss of femininity is a common concern after gynecologic cancer treatment.
Fears about whether you can achieve orgasm may make you feel uncomfortable about having sex. Your partner may have concerns about emotionally pressuring you to have sex.
Know that these sexual concerns are normal after cancer treatment, and you and your partner can use techniques to improve your sex life.
FAQ
How do I prepare for changes in sexuality?
While it may not be the first thing on your mind as you’re anticipating cancer treatment, the best time to talk about expected changes to your sex life is before treatment. Many healthcare professionals bring up sexual health effects as they discuss treatment, but not all do. If you’ve already completed treatment, it’s not too late. You can discuss sexual changes and management with your cancer care team anytime.
What can I do if I have vaginal dryness after treatment?
If you’re experiencing vaginal dryness after treatment, using a lubricant may make sex more comfortable. Oil-based lubricants can increase your risk of getting a yeast infection, so it’s a good idea to select a water-based gel.
You may also consider using a vaginal moisturizer which is not the same as a vaginal lubricant. Unlike a vaginal lubricant which is used right before penetration, vaginal moisturizers can be applied several times a week to keep the vagina moisturized.
Should I talk to my doctor about using a dilator?
Yes. If you’ve undergone radiation therapy to the pelvis, cervix, or vagina, you may experience scarring, narrowing, and shortening of the vagina (vaginal stenosis). Your healthcare provider may recommend using a dilator to stretch the wall of the vagina.
How do I manage negative self-talk?
Recovering from the effects of cancer treatment may be challenging. You may experience negative thoughts about the changes that have happened to your body. The first step is to become aware of these thoughts. Then, shift your attention to the good things in your life and your positive features. Practicing positive affirmations and mindfulness exercises may also foster your self-confidence. Consider participating in counseling with a mental health professional.
How do I know how my body will respond to sex after treatment?
After cancer treatment, your body may respond differently when touched. Take the time to get to know your body. Learn what’s pleasurable and what doesn’t feel good so you can better help your partner understand your needs. Get your healthcare team’s approval about using a vibrator to help improve blood flow to your genitals.
How can I build sexual excitement?
Schedule it. Planning to have sex – or to be intimate – involves talking about it with your partner. It’s an excellent opportunity to discuss the sexual activities you want to engage in and what works for you after cancer treatment. It also gives you time to build anticipation, get enough rest, and set the mood.
I’m not ready for sexual intercourse, what can I do?
Try sexual intimacy. It doesn’t have to be about penetration. Propose scheduling some relaxed time together to be sexually intimate. This includes being physically and emotionally close, like holding, touching, massaging, and kissing without intercourse.
Can a sex therapist help?
Yes. A sex therapist is a trained professional who can help you and your partner find ways to build a healthy and satisfying sex life. Some health plans cover sex therapy; call your insurance to see if it’s a covered benefit.
Your sexuality, libido, and the pleasure you derive from sex may be significantly impacted after gynecologic cancer treatment. You may be tempted to avoid the sexuality conversation altogether, but communication is key. Talk openly to your cancer care team and your partner, if you have one, about your concerns and how you feel. With the right support, you can have a satisfying and healthy sex life.
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