My husband said all the right things to me after my lumpectomy. He told me that I looked beautiful and feminine and that he found me very desirable. I, of course, believed none of it. What could possibly be sexy about a woman with a scarred, gimpy breast and the whiff of life-threatening disease hanging about her?
When I got diagnosed with breast cancer at 32, I braced myself for surgery, nausea, and fear. What I didn’t count on were the changes in the bedroom.
Many young survivors are surprised by this discovery: sex just isn’t the same after cancer. Some changes are subtle, like wearing a t-shirt during sex so a partner can’t see your scars or avoiding certain positions that are painful now. Some changes are more obvious, like making love without interfering with g-tubes or coping with erectile dysfunction.
Confronting these new realities in bed can be especially difficult for young people. Sage Bolte, an oncology social worker who specializes in sexual health for young survivors, says that within a matter of months, a young person can go from being a player to being impotent. “You are at your sexual peak at diagnosis, so your fall is harder than most,” she explains.
One moment you are enjoying the freedom of youthful sex, discovering what gives you pleasure, and the next you are explaining why your vagina is bone dry to a new partner. “It is very different than a woman who is already in her sixties has gone through menopause naturally. They have adapted–and so have their friends and partners–to a lower libido, and you haven’t had time to,” says Bolte.
Young people now have to figure out when to talk about a prosthetic testicle or reconstructed breast with someone they are dating–someone who has probably never encountered these changes before. One young survivor of testicular cancer asked me, “How do you tell a girl that you only have one ball? I think my libido would be better if I wasn’t scared about that.”
Young survivors are more likely to have moved back in with our parents in order to get through treatment, and now we have to bring dates home to Mom and Dad’s. We are also more likely to be uninsured, and challenges like erectile dysfunction can go untreated.
And, if we are female and received chemo, the odds are very good that our libido has taken a nose dive, leaving our partners–who remain in their sexual prime–wondering if once a month is as good as it gets. Sarah, who was diagnosed with breast cancer at 31, said treatment took “away most of my desire. I hate that. Hate that. It’s such a personal part of someone to destroy.”
Some young people become resigned to these changes—as if the loss of physical intimacy were the price we pay for survival. But cancer does not have to mean the end of good sex.
There is a long list of tips and products that can significantly boost our sexual experience after treatment. We just have to seek them out. Bolte says, “Survivors may have compensated for fatigue, chemo brain, shortness of breath. Now it’s about giving them permission to do the same in their sex lives.”
Don’t hesitate to tap the expertise of your medical team. Urologists and gynecologists are trained to talk about sexual function, and most cancer centers and hospitals have therapists on staff specializing in cancer and sexual health.
It’s worth the effort. Michelle was 26 when she was diagnosed with cervical cancer. Her treatment required a hysterectomy and pelvic radiation and left her in menopause. “There was no sexual contact in my house for eight months,” she told me. But over time, she and her husband talked and explored their way back to each other.
“As survivors, we want to have a healthy sex life, but it takes work,” says Michelle. “It’s like when you want a great body, you have to go to the gym, and in the first few months you don’t feel good, it hurts, it takes practice. Sometimes we expect to go right back to having sex and having it feel good. We forget to allow ourselves the time. But you have to take the time and do the work to get to a place where it feels good again.”