Sexuality for Women on Chemotherapy

It is very common for most all women dealing with the process and treatment that comes with cancer be stricken with the feelings that they are losing control of their sexual self and lives. The topic of sexual health and intimacy do not always come up in conversation with your doctors, so do not hesitate to ask your questions at any time. Sexual intimacy wholeness is a very important aspect of recovery and healing your entire self. Here we will discuss the most common issues and questions regarding the female body and chemotherapy.

What are the most commonly reported concerns with female sexuality and chemotherapy?

The most commonly reported issues females are facing before, during and after treatments are loss of libido and sexual drive, inability to orgasm, pain during sex, and the loss of finding sex exciting or important.

I have noticed my vagina is changing, but I can’t exactly describe how. What are the changes that can happen to a vagina during chemo treatment?

The most often reported side effect of chemo is vaginal dryness of varying degrees. For some it is barely noticed, and for others, the dryness is severe, painful, and causes tears and bleeding in the skin. Vaginal atrophy, or inflammation, shrinking and thinning of the tissues, is caused by drops in the hormone and lack of estrogen in to the vaginal tissues. If you have had any surgical intervention in the vaginal area, this can cause vaginal shortening, which can make sexual intercourse feel different, and may take some adjustment. Radiation therapies around the vaginal area can cause scarring, or fibrosis.

Here are a few steps you can take to alleviate the vaginal issues:

-Avoid using Vaseline or skin lotion as any sort of lubrication. These can damage condoms and raises the chance of having a yeast infection greatly.

-Use lubrication before, during and after your intimate acts. Lube can be applied to the vagina, the penis and shaft, fingers, dilator sets, toys, vibrators, and more. Lubrication is important for those with sensitive skin, as dryness can cause rips and tears, which can lead to infections.

-Avoid using lubrications that are not all natural, or medical-grade with no added extras. Flavors, scents, and added options (like warming, cooling, tingling, etc.) can be fun once or twice, but these can cause more issues with fragile skin. Plus, the added sugars can create the perfect breeding zones for yeast infection causing bacteria.

-Using a vaginal moisturizer two to three times per week, regardless of sexual activity. These are hormone-free creams that help the tissues regain and replenish moisture, which allows for more pain-free movement and foreplay.

-After your radiation therapy is complete, using a dilator set to help open and stretch sensitive tissues of the vagina. Using a dilator set can help reduce scar tissue and helps to make intercourse and pelvic exams more comfortable.

-In certain cases, some form of vaginal estrogens may be prescribed. They come in many forms including creams, tablets, or rings. Creams are prescribed and used for weeks. Tablets are usually inserted a few times a week. Or the ring, which excretes a steady stream of estrogen for a three-month period. Only a small amount of estrogen is absorbed into the blood stream via these methods. Before deciding on this method, discuss the benefits and risks of taking and using any hormone treatments, especially if you have hormone positive tumors or growths.

Can I have sexual intercourse while on chemo?

In most cases, yes. There are a few things to consider when making this decision.

Generally, as long as energy, interest and physical comfort levels allow, you are fine to engage in sexual activity. That said, intimacy can be achieved in numerous ways, not solely limited to sex. After radiation and surgery, your partner may not be interested in sex. Hugging, cuddling, massaging, and holding hands may be just what you are looking for.

  • If you had any surgery involving the pelvic area you might need to give yourself some extra time for healing. This means avoiding any penetrative sex, vaginal or rectal, including anything that could be used for penetration.
  • If you are being treated for oral cancer, discuss oral sex activities with your doctor before proceeding.
  • If your blood cells have a low white count or low platelet count, you will need to refrain from any sexual activity in the vaginal and anal area. When our platelets fall below 50,000, our bodies are more susceptible to infection and illness.

Will my sexuality change after I finish my chemotherapy?

Because sexuality encompasses much more than just sex, there is a very high chance that your sexuality will change. There are physical, emotional, psychological and social aspects to sex. Some may not be affected at all, while others may find that nothing they once enjoyed physically feels the same and might even hurt now. You might face mental blocks that do not allow you to find orgasm as easily, or in the same method, that you did before. You might find that you need to regain your own sexuality and re-discover what you do like and what your body now needs to relax and find pleasure.

If you find yourself having difficulty with intimacy or intercourse before, during or after your chemotherapy treatment, do not hesitate to contact your doctor, nurse, Oncologist, or healthcare advocate to point you in the right direction for help. There are many doctors and therapists that now specialize in cancer treatments and sexual health.

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