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Inspiring Intimacy (and Having Sex) During Cancer

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Cancer affects every aspect of your – and your partner’s – life and it can feel almost impossible to find the time, energy and desire for intimacy of any kind. Treatment can be intense and invasive and cause physical changes in the body that, matched with the emotional strain, often extinguish any sense of sexual fire that might still be glowing inside. But while the physical and psychological effects are incredibly real, they don’t have to be barriers in the bedroom. There are a multitude of tools that women can use to help them build, maintain and celebrate their sexuality during every stage of cancer treatment.

The brain is women’s No. 1 most important sex organ. When the mind is distracted, diverted or clouded by stress, sex is often the last activity on her to-do list and orgasms simply don’t come easily – or at all. Logically, cancer causes myriad emotional stresses (depression, anxiety, guilt, fear) but it also wreaks havoc on a woman’s sexual desire, self-worth, self-esteem, and the physical changes that come before, during and after treatment make many women feel simply unsexy.

And even with a positive mindset, the physical effects of cancer can make sex difficult, even painful, which leaves some women feeling “broken” and unequipped to deal with the way their bodies have changed. Vaginal dryness, painful intercourse, nausea, extreme fatigue, loss of sensation – they’re all very common and very real obstacles to navigate alongside what can be an incredibly scary disease. Especially when mastectomy or other surgeries are involved.

But the good news is that, while the mind and body undergo change, your orgasms probably won’t! The American Cancer society reports that almost all women maintain their orgasmic abilities after treatment and that it may be as easy as before – it just takes practice. Fortunately, the experimentation process alone is a wonderfully effective way to build and strengthen intimacy with a partner, even if intercourse or orgasm isn’t the end result!

So as you prepare to make pleasure practice a regular part of your life, here are some important factors to keep in mind as you learn new ways to enjoy a healthy sex life:

Treatment can be exhausting, so schedule sex for times you feel most rested. Your partner can help with chores and other tiresome activities around the house to help you preserve energy. Just avoid getting busy after eating a heavy meal.

Getting in the mood can feel like a major feat, so try new forms of foreplay to help put your mind in the game. Sexy music, erotica or even soft porn can get juices flowing, and sensual massage is an intimate and effective way to relax, soothe nerves, and feel comfortable to move on to the next steps. A warm bath or shower with scented candles or oils also can help stimulate the senses – especially if you invite your partner to join in.

Play with positions. Before treatment, reverse cowgirl or doggy style may have been your go-to’s, but they put incredible strain on joints and energy levels. Try positions that require less physical exertion: lie on your side (spooning-style) or on your back with your hips at the edge of the bed. These positions help you feel deep and satisfying pleasure while keeping you and your partner intimately close, and make it easier for your body to relax and get into the groove.

Sex might feel different and you may need additional stimulation to help you feel pleasure in the ways you’re accustomed to, especially when it comes to having an orgasm. Sex toys are a fun and effective way to give your (or your partner’s) fingers a rest and can even enhance sensations in an entirely new way, making orgasm come easier and faster. Try massaging a mini vibrator on your clitoris during foreplay or in certain sex positions you find comfortable and see how you feel. You might be surprised by how much you (and your partner!) love it.

Lubrication is key for comfortable and pleasurable intercourse, but chemotherapy, stress and so many other factors (dehydration, distraction, menopause) get in the way of your vagina’s usual waterworks. An all-natural water-based or silicone-based lubricant is recommended to keep sex slick and smooth while preventing any kind of chafing, rubbing and general discomfort that vaginal dryness can cause.

Sexual pleasure beyond intercourse can satisfy both partners when penetration just isn’t an option. Intimacy is so much more than penetration and the sense of touch – and being touched – can be incredibly erotic while connecting you and your partner (literally and figuratively) at a different level. Caress, hug and massage the skin and use hands to stimulate sensitive areas while being mindful of areas to avoid. The neck, forearms, stomach, inner thigh and even feet are erogenous zones not to be missed! And remember: orgasms don’t have to be your goal.

Sex during chemo can require extra precautions: When blood counts are low, avoid intercourse and oral stimulation as they can spread bacteria and increase risk of infection. Birth control is a must if pregnancy is possible.

Communicate what you’re feeling, both emotionally and physically. You’re both learning how to be intimate with each other in a completely new way and it’s important to give each other space to share concerns, feelings and ideas. Easier said than done, but it feels less scary each time you open up.

A good sense of humor can help you get through some of the most awkward, uncomfortable and embarrassing parts of the process. It’s OK to laugh at sounds, smells or situations that are way out of your comfort zones – you’re in it together (in more ways than one) and you’ll feel stronger with every chuckle.

There are a wide variety of trusted resources available online and at various treatment centers to learn more about sexual health before, during and after cancer – the Dana-Farber Cancer Institute (one of the nation’s leading cancer hospitals) even devotes an entire program to it. Don’t feel afraid to ask your doctor for more information; sex and intimacy is one of the most common concerns of women and couples undergoing treatment. You’re not alone: breast cancer affects 1 in 8 U.S. women at some point in their lives, and preserving the intimate relationships they hold with their partners – and especially themselves – is key to maintaining a healthy and happy sense of wellbeing during one of the most stressful times in life.