Breast cancer Rehab for Physiotherapists Course

This article “Sex therapy after cancer” by Relationships Ireland was approved for the course by Siobhan O’ Reilly Bracken MISCP MPA CLT MSc

Physiotherapists may refer patients to specialists such as Relationships Ireland for sex therapy after breast cancer.
Ph: Relationships Ireland on 01 678 5256


Sex therapy after Cancer

Individuals diagnosed with cancer face many challenges during treatment and beyond. Side effects are common with most treatments and can vary from nausea and fatigue to problems with intimacy and sexuality. Many cancer patients experience sexual side effects which can be quite distressing for both the patient and their partner.

When faced with a cancer diagnosis and the challenges of treatment, it is not surprising that feelings of intimacy and sexual desire may decrease. Physical changes can have an effect on one’s feelings of attractiveness. Individuals with breast cancers or cancers of the head and neck often develop body image concerns which can result
in sexual side effects. Psychological issues can also arise due to a cancer diagnosis. The diagnosis itself may cause anxiety or depression and these conditions, or the medication used to treat them, can result in side effects that influence libido or sexual functioning.

Sexual Side Effects of Cancer Treatments
Various treatments for cancers can affect sexual functioning and one’s desire to be intimate.

Chemotherapy: Chemotherapy can affect libido for men and women because it can cause side effects such as diarrhoea, fatigue, mouth sores, and nausea, which make people feel unwell and uninterested in sex.

Radiation therapy: Depending on the organ being treated, radiation therapy can cause sexual and physical side effects that may reduce one’s interest in sex. For example, any radiation therapy affecting the gastrointestinal tract can lead to pain and stenosis (shortening) in structures such as the oesophagus, and/or diarrhoea. This can then have an effect on one’s libido.

Surgery: Even though surgeons try to prevent many nerves from being damaged during surgery to remove a tumour, sometimes this is not possible. Severed nerves can contribute to sexual issues. Following prostatectomy, men may experience erectile dysfunction or urinary incontinence which may stop them from wanting to be intimate with their partner. Women who have undergone an oophorectomy to remove the ovaries can experience a decrease in their libido because of the resulting decline in circulating oestrogen and testosterone levels. Having a mastectomy to treat breast cancer can cause women to develop an altered body image which can result in reduced interest in sex.

Hormone Therapy: Hormone therapy for the treatment of cancers can have many sexual side effects. For men these can include; erectile difficulties, altered body image, reduced self-confidence, decreased feelings of attractiveness, and painful ejaculations. For women, the side effects of hormone therapy can include; vaginal dryness, painful intercourse, loss of energy, decreased feelings of attractiveness, and difficulty achieving orgasm.

The Importance of Communicating and Connecting with Your Partner
Here are some tips to help you to improve communication between you and your partner so as to maintain or renew your sexual connection. However, if your problems persist, your concerns need to be addressed with your doctor.
• Openly discuss with your partner how you are feeling emotionally and what physical difficulties you are experiencing.
• Encourage your partner to talk about their concerns and needs too.
• Recognise that intimacy doesn’t just mean sexual intercourse. There are lots of ways to be intimate with your partner such as kissing, hugging or cuddling.
• Lubricants and moisturisers can be very effective for relieving vaginal dryness.
• If scars or surgery make you feel uncomfortable with your body then try wearing clothing or lingerie that makes you feel more relaxed, or you could try keeping the room dimly lit.
• Mix up your routine by trying different sexual positions, lighting candles, playing soft music, having sex in a place other than your bedroom, or experimenting with intimacy aids.
• To prevent fatigue, try having a nap or picking a time of the day when you have the most energy to engage in sexual activity.

Loss of sexual interest is a complicated problem but being and having an understanding and supportive partner is very helpful. Couples counselling or psychosexual therapy can be very beneficial for couples who are affected by cancer. If you would like to find out more or book an appointment with a certified Relationships Ireland counsellor, you can contact us here. A one hour Psyschosexual counselling session costs €85.00. Relationships Ireland operate a cancellation policy. For more details click here.

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