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By Laurie Sammeth, Contributing Writer, myOptumHealth

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When you have cancer, the closeness and comfort of a partner is often more important than ever. But your illness may take up much of your time and energy, leaving little left for intimacy. The emotional effects of cancer and its treatments are often enough to douse your desire for sex. Some cancer treatments may cause side effects that directly affect your physical ability to take part in and enjoy sexual intimacy.

Different issues for men and women

Side effects of cancer and its treatment may reduce sex drive (libido) and cause both men and women to feel less attractive. Different types of cancer may cause unique issues for men and women.

In men, treatments for prostate or colon cancer can cause erectile dysfunction (also called ED or impotence).

In women, treatment of pelvic cancers can take a physical toll. Treatment can lead to severe vaginal dryness and pain with intercourse. It can also cause loss of sensation and trouble having an orgasm. Breast cancer and mastectomy may affect how a woman feels about her physical attractiveness.

How cancer treatment may affect your sexuality

Many factors, including your type of cancer and treatment, can impact your sexual function.

• Surgery. The physical and after effects of any type of surgery can affect your sexual function. Surgeries on the pelvic organs - like the uterus, ovaries, bladder, prostate, testicles, rectum and colon, or surgery for breast cancer may literally hit closer to home in terms of sexual function. The effects surgery may have on your sexual function depend on:
• • Your abilities before surgery
  • Your overall health
  • Your age
  • The size and location of the cancer
  • The amount of tissue taken out
• Chemotherapy often has a host of side effects, such as:
  • Nausea
  • Vomiting
  • Fatigue
  • Diarrhea
  • Hair loss
  • Weight gain

  These can sap energy, reduce sexual desire and lower self-esteem. In women, chemo can lead to vaginal dryness, pain during intercourse and problems having an orgasm. After chemo, men sometimes have trouble making testosterone. This can interfere with sexual functioning.

• Radiation side effects are similar to those of chemo. They can reduce the desire for sex. Women who have radiation treatment in the pelvic area may have changes in their vaginal lining, making intercourse painful. Men may have sexual problems, including ED, after radiation. Their risk for these problems is greater if they smoke or have heart disease, high blood pressure or diabetes.
• Hormone therapy to treat prostate cancer may lower a man's hormone levels. This affects his desire for sex as well as his ability to have an erection or orgasm.

Other factors

• Psychological factors. Anxiety and depression that may go along with cancer can affect self-image and desire for sex.
• Chronic pain is often part of having cancer. Both the pain itself and the medications for it can affect sexual desire and performance.
• Myths about cancer and sex may lead some people to avoid intimacy. It's important to know that these are myths and not true. For instance, sex will not make cancer worse. Cancer treatments, such as radiation or chemotherapy, have no effects on anyone other than the person who had the treatments.

Suggestions for overcoming barriers and restoring intimacy

• Communicate. Talk with your partner and your doctor. Let your doctor know about any sexual function problems you are having. Medical devices and medications may help. Tell your doctor if you feel depressed or anxious, so you can get help. Share your feelings and let your partner know that you still want to be close, but may need to make some changes in your physical relationship.
• Maintain physical closeness. Besides intercourse, there are other ways to stay physically connected, such as cuddling, kissing and touching. If you have problems, make adjustments and explore new ways to achieve sexual pleasure. Physical contact can help you cope with the stress of not feeling well.
• Enhance your self-image. You may feel less attractive because of hair loss, weight gain or loss, or some other effect of your treatment. Remember that there's a lot more to you than the physical. Your inner qualities can still shine through. When you are ready, you may also want to take action to improve your self-image. Medical options, such as breast reconstruction or testicular prosthesis; medications or devices to improve erectile function; or simple boosts like buying a wig or new clothing may help you feel better about how you look and feel.

View the original Cancer and intimacy: physical and emotional issues article on myOptumHealth.com 

SOURCES:

• Lenahan PM. Sexual health and chronic illness. Clinics in Family Practice. 2004;6:955-973.

• American Cancer Society. Staying sexually healthy after being treated for cancer. Accessed: 10/23/2007

• National Cancer Institute. Sexuality and reproductive issues. Accessed: 10/23/2007