Many people undergoing treatment for cancer notice a decrease in sexual desire. Sexual desire may decrease due to physical pain, physical exhaustion, mental exhaustion, GI distress, nausea, skin irritation, hormonal changes, anxiety, depression, respiratory distress, loss of sexual self-esteem, negative body image, etc. In addition, relationship distress, which can be common during cancer treatment, can impact sexual desire and may become an additional barrier for couples.
Couples often report wanting to stay sexually connected in some way during cancer treatment, despite the many barriers. Consider the following suggestions for maintaining physical intimacy during cancer treatment:
- Be realistic: Unrealistic expectations can cause resentment and added relationship distress during a time that is already full of stress! The reality is that the partner undergoing cancer treatment may not be able to physically achieve penetrative sex. Both partners will need to adjust to this reality. Also, the other partner may also have their sexual desire impacted by the additional life stress from their partner’s cancer treatment and seeing their partner deteriorate during treatment. Both partners need to set realistic and achievable goals about connecting sexually during this difficult time. It is okay for sex to diminish or drop off completely for a period of time—even an extended period of time! Sexual connections can be reestablished once the partner with cancer is feeling better.
- Consider alternatives to penetrative sex: Just because penetrative sex is not an option, it does not mean you cannot connect intimately with your partner in other ways. Make sure to incorporate “outercourse” sexual activities (sexual activities outside of penetrative sex) if physically possible. You and your partner may find you want to increase the amount of affection you give each other such as hand holding, cuddling, kissing, massage, taking a bath together, etc. While these are not a replacement of sexual activity, this type of affection can have even more importance if sexual activities are not achievable.
- Schedule time to connect: Many couples find that connecting sexually doesn’t happen unless they schedule it—even when health issues aren’t a barrier. There are several advantages to scheduling time to sexually connect for couples where one partner is undergoing cancer treatment. First, the couple can schedule times to connect around treatment, avoiding the worst days, and taking advantage of times where the partner undergoing treatment generally has a decrease in symptoms. Second, scheduling allows each partner time to prepare. For the partner undergoing cancer treatment this might mean scheduling activities on these days, taking a nap and . Thirdly, even if the couple struggles to do something sexual on the scheduled time (as life and reactions to cancer treatment are unpredictable) most couples feel reassured that they are at least still attempting to sexually connect. In addition, even if a sexual activity cannot be achieved during the scheduled times couples can adjust and engage in massage or cuddling.
- Get creative with date ideas: Its important not to neglect “date night” or engaging in activities you both enjoy. Couples who do not feel as emotionally connected to each other usually engage in less sexual activity. Therefore in order maintain this emotional connection (and hopefully eliminate another barrier to sexual desire) try to keep some version of a date night. During cancer treatment this obviously may mean doing more dates at home. Date night ideas at home could include taking a sensual bath together while listening to your favorite music, watching a movie, cooking together, playing a board game, building a puzzle, embarking on an artistic activity together like painting, having a picnic in your backyard, etc. Get creative—try to bring some version of the activities you used to enjoy with each other inside. One couple set up a mini golf course in their house. Another couple who loved going to the theater, decided to rent OnDemand live streams of the opera and other concerts they wanted to see. When the partner undergoing cancer treatment has moments of decreased symptoms take advantage of this time and do something outside of the home.
- Get support: Finally, its okay and normal to be upset about the changes caused by cancer treatment that are impacting your sexuality, sex life and relationship—both as the partner with cancer, and the partner without. If you find that you and/or your partner are having troubling adjusting to these changes it may be useful for one or both of you to seek counseling. Consider finding a local support group too. Some hospitals offer support groups for both those undergoing cancer treatment and their partners. Also, make sure you both are engaging in enough self-care including spending time with friends, exercising (if possible), engaging in hobbies you enjoy (again if possible), getting enough sleep, etc.