Sexual wellbeing

Three key messages

  1. After treatment, experiencing changes in sexuality is very common and may vary depending on the type of cancer and the treatment you received.
  2. It is normal for any cancer patient to experience changes and there are many things you can do to help manage these effects.
  3. Psychosexual counselling provides a safe, confidential and supportive environment for you to talk about your sexual wellbeing.

Introduction

Sexuality is a core component of being human. There are many factors which influence how a person perceives and experiences their sexuality, including social, cultural and familial factors.

Cancer and its treatment can change your body and how you feel about yourself, which can affect your sexuality. The most obvious impacts are physical. Treatment for some types of cancer can directly affect the physical ability to have sex or to enjoy it. More generally, many cancer treatments can affect your ability or desire to be intimate with others.

Most people who have had cancer treatment say they have experienced issues with sexuality and intimacy. Some find that change in their sexuality is temporary. Others have to adapt to long-term changes, and may find this to be the most difficult aspect of life after cancer.

Changes to sexuality or sexual intimacy are very common following treatment for cancer.  Research suggest that overall quality of life and general wellbeing are can often be lower for those who do experience sexual difficulties such as changes in libido, painful sexual intercourse or erectile difficulties.

It is possible, however, for appropriate sexual counselling to help cancer patients to strengthen a relationship, improve communication with a partner, and lead to new ways to express sexuality and intimacy.

For more information about Sexual Wellbeing, please submit a Request a Wellbeing after Cancer Callback form and a Wellbeing after Cancer Registered Nurse will contact you.

Fertility

Some cancer treatments can cause infertility (difficulty conceiving a baby), which can be temporary or permanent. When people learn that they may be permanently infertile, they often feel a great sense of loss. People who did not get a chance to think about their fertility until treatment was over say the emotions can be especially strong. As well as talking with your partner, it may help to talk with a counsellor, sexual therapist, oncologist, urologist or oncology nurse.

Options after treatment - men

  • Some men are able to conceive naturally; although you might be advised to wait a certain period after treatment before fathering a child.
  • Techniques include intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI).
  • Some men use donor sperm to conceive a child.

Options after treatment - women

  •  If you have eggs and a uterus, you may be able to conceive naturally.
  • If you cannot use your own eggs, you may use donor eggs or embryos. You may also consider choosing a surrogate to carry your embryo or a donor embryo for you.

Coping strategies

  • Find support from friends and family
  • Gather information
  • Explore peer support
  • Consider counselling

Useful Cancer Council WA publications (webinars, podcasts and other resources) include:

  • Maybe later baby? A guide to fertility for young people after cancer
  • Fertility and cancer
  • Cancer treatment and fertility

Menopause

Early menopause (or premature ovarian insufficiency or POI) is the term for menopause that occurs before the age of 40. When menopause starts suddenly, the symptoms are usually more severe than natural menopause because your body hasn’t had time to get used to the gradual loss of hormones. Premature menopause may also cause bones to weaken (known as osteoporosis or osteopenia). The loss of menstruation and fertility earlier than you expected may affect your sense of identity, or make you feel older than your age or friends. You may feel less feminine, and worry that you are less attractive.

Coping with menopause

Cancer treatments can cause symptoms such as hot flushes, changes in menstrual cycle, troublesome vaginal symptoms, and changes in sexual libido. For younger women, these symptoms are often a shock, as they may be many years away from undergoing natural menopause. For some women diagnosed with cancer, pre-existing Hormone Therapy (HT) is stopped. Those women who were taking HT to manage their menopause before their cancer diagnosis may also feel their menopausal symptoms coming back and need assistance to manage these.

You can speak to your doctor about any concerns and may be referred to specialised services for ongoing advice at King Edward Memorial Hospital, including:

Men experience symptoms too!

Men can experience changes in sexuality, including menopausal changes after commencing androgen deprivation therapy. These symptoms may be hot flushes and sexual side effects such as decrease in libido and erectile dysfunction. 

Managing these symptoms is important for your general wellbeing; as is finding a doctor nurse or counsellor who is comfortable discussing sexual issues with you. Other recomended resources fro men include:

Sexuality

After treatment, experiencing changes in sexuality is very common. Your experience can vary depending on the type of cancer you were diagnosed with and the treatments you received. Changes in sexuality may be physical or emotional, which can be very impactful whether you have a partner or not. Physical side effects from treatment can sometimes cause sexual discomfort or make sexual penetration painful. You may like to explore other types of sexual intimacy or find other ways to climax. It is important to give yourself time to adapt to these changes.

The experience of having cancer can also reduce your desire for sex (libido).  These changes can affect the way you feel about yourself and make you feel self-conscious. Whatever your experience is, understand that it is normal to feel these changes after cancer and there are many things you can do to help manage these effects.

LGBTQI

It is important to feel that your sexuality is respected when discussing how treatment will affect you. Recognition and acceptance of your sexuality is a crucial part of receiving support. Your clinical team should openly discuss your sexual needs and support you throughout treatment. Try to find a doctor, nurse or counsellor who helps you feel at ease discussing sexual issues and relationships. You could also contact QLife, a national counselling and referral service for people who are lesbian, gay, bisexual, trans and/or intersex (LGBTQI).

Visit QLife or call 1800 184 527.

Cancer, disability and sexuality

Coping with cancer can be difficult. When you have a disability, it can be even more challenging. If you live with a disability, speak to your health care provider for a referral to a clinical psychosexual therapist or psychologist who has experience working with individuals living with a disability, and also think about a referral to SECCA (Sexuality Education Counselling and Consulting Agency) via your NDIS plan, which can include counselling to talk about your concerns and offer strategies to support your sexuality after cancer.

Other useful resources are:

Resuming sexual activity after treatment

Sexuality and intimacy after a cancer diagnosis may be different, but this does not mean it will be better or worse. Your preferred sexual positions may become less comfortable temporarily or change over time. To adapt to these changes, you may need to develop more openness and confidence, in and out of the bedroom. Try to keep an open mind about ways to feel sexual pleasure.

Why see a Psychosexual Counsellor?

Counselling can have many benefits for you, including improved life satisfaction, solutions to problems, relationship improvement, improved health and significant reduction in feelings of distress.

At times it is likely that you will have some uncomfortable feelings. This is not unusual and can mean that change is happening for you. 

Sexual difficulties following a cancer diagnosis and treatment are common:  men or women who are otherwise healthy may experience issues such as low sexual self-esteem and changes to emotional intimacy, with vaginal dryness and painful intercourse for women, and erectile difficulties for men. While it is normal for individuals and those within relationships to experience the ebb and flow of sexuality and sexual activity related to desire and frequency of sexual activity and intimacy, this can be further impacted by illnesses or certain medical treatments.

Counselling provides a safe, confidential and supportive environment for you to talk about your sexual wellbeing. There are no physical examinations, no nudity and no sexual touch. Sex therapy is a ‘talk therapy’ which offers practical information and strategies in managing any sexual and relationship changes. Counselling can support you to:

  • Enhance your sexuality and intimacy for you as an individual or for you in your relationship
  • Help understand related changes to your body image and sexual self-esteem following a cancer diagnosis/treatment
  • Maintain healthy sexual functioning and sex life, address sexual difficulties and awkwardness with connecting sexually
  • Redevelop a healthy sex-life balance

An Accredited Psychosexual Therapist can also provide a link to other allied health services as needed, to provide a holistic approach to support you, and/or your partner.

Important links

The expert content on this page has been informed by Helena Green, Relationship and Sexuality Counsellor, Clinical Psychosexual Therapist, Clinical Sexologist. Helena specialises in supporting couples and individuals to overcome sexual and relationship difficulties, and enhance and maintain sexuality and intimacy across all life stages.