Sexuality, Intimacy and Cancer
Contents
Speak to a qualified cancer nurse
Call us on 13 11 20
Avg. connection time: 25 secs
Sexuality, Intimacy and Cancer
Resuming sexual activity after treatment
While some people find sexual intimacy is the last thing on their mind during treatment, others say they have an increased need for closeness. An intimate connection with a partner can make you feel loved and supported as you come to terms with the impact of cancer. However, cancer can strain relationships, particularly if you had relationship or intimacy problems before the diagnosis.
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 or activities may become less comfortable temporarily or change over time. It’s natural to feel grief at the loss of your previous sex life or desire. To adapt, you may need to try and be more open to exploring different ways to feel sexual pleasure.
Adapting to changes
There are several ways to prepare for sex and intimacy changes during or after cancer treatment:
Talk openly with your partner – Share any concerns you have about having sex or being intimate. Tell them when you are ready to have sex, what level of intimacy and intensity you prefer, if they should do anything differently and how they can help you to feel pleasure. Some people have had a good sex life but have never spoken openly about it before. It can feel like it might be too awkward, and you might be tempted to avoid it, but having these talks can be helpful. Start with an easy topic and build up to the more difficult ones.
Ask your partner how they are feeling – They may be worried about hurting you or appearing too eager. Sometimes people avoid all contact because they don’t know how much touch is okay. You can help satisfy your partner by exploring what they want and what you are able to do.
Take it slowly – It may be easier to start with cuddles or a sensual massage, rather than penetrative sex. Talk about this before you start so you both know what the limits are. You can withdraw your consent at any time, even if you have already begun to have sex. Many people find that things often improve with communication, time and practice.
Plan ahead – You may need to plan when to have sex because of things like vaginal lubricants, erection devices, incontinence or stomas. Think about the timing of your medicines – some may reduce pain and make you feel more comfortable, or they might make you feel sleepy and not like being intimate.
Explore different ways to have sex – How you used to enjoy having sex may now be more difficult or not possible after cancer treatment. This can be upsetting, but most people can find satisfying new options. Keep an open mind about ways to feel sexual pleasure – you may want to explore different erogenous zones, such as the breasts, ears or thighs; mutual masturbation; oral sex; personal lubricants; vibrators and other sex toys; erotic images and stories; and sexual fantasies.
Focus on other aspects of your relationship – Many relationships do not depend on sex, and you may or may not see sex as being important. Either way, it can be helpful to talk about how you and your partner feel about your sex life, and work out any differences you may have. Spend time together doing other things you both enjoy, which can also bring you closer. That way, sex isn’t the only way that you show your affection and share intimacy, and this can take any pressure off your sex life.
Try exploring your sexuality on your own – Touch and masturbation can help you to understand what has changed and what feels good in a way that you have complete control over. You can take your time to explore how your body reacts, without feeling any pressure to “perform” or to keep going if you don’t really want to. A vibrator or other sex toys may increase sensation and bring a sense of fun. Once you have begun to feel comfortable with exploring your body, you can show your partner what feels good and works best, what doesn’t work and what has changed.
Use relaxation and meditation techniques – Stress and anxiety can make it much harder to feel in the mood for intimacy. Making time for meditation or mindfulness may help you relax and stay in the moment with your partner. There are many free apps and podcasts that can guide you through learning relaxation techniques. Treatment centres often run programs where you can learn to meditate. Cancer Council also has a podcast with meditation and relaxation exercises. Listen to our ‘Finding Calm During Cancer’ podcast series.
Seek assistance – Talk to any member of your health care team or ask your doctor for a referral to a sexual health physician, sex therapist or psychosexual counsellor to help you find solutions.
What if I identify as LGBTQI+?
It is important to feel that your sexual orientation and gender identity are respected when discussing how treatment will affect you. Your health care team should openly discuss your sexual needs and support you and your partner throughout treatment.
Coming out as LGBTQI+ to your treatment team is a personal choice. It’s up to you whether you want to share your sexual orientation, preferred pronouns, sex or gender. It may make it easier for you to discuss your sexual health and for your treatment team to give you the most relevant information or connect you to LGBTQI+ support groups.
You can call Cancer Council 13 11 20 to talk through your concerns and ask for information.
You can visit QLife, a national counselling and referral service for people who are lesbian, gay, bisexual, trans, queer or questioning and/or intersex or call them on 1800 184 527.
If you have a partner, you can encourage them to come to your appointments. This lets your doctor know who’s important to you and will mean your partner can be included in any discussions.
Before your first appointment, it’s okay to phone or email your doctor to find out if they are LGBTQI+ friendly. You could ask, “My wife will attend the appointment with me, we are both women, will we be welcome at your clinic?” You can ask your GP to include information about you in their referring letter, such as your sexual orientation, or preferred name and pronouns.
“I was deliberately out as gay to my doctor and nurses. They handled it well, acknowledged my husband, and we use joint decision-making in addressing sexual changes.” SIMON
Communicating with your partner
Misunderstandings, different expectations and conflicting ways of dealing with change, can all cause tension within a relationship. The key to adjusting to sexual changes after cancer is communication.
It may help to talk about how you’re both feeling, your concerns and your needs, as well as ways you can adapt intimacy and sexual activities during and after cancer treatment. Even people who are comfortable sharing their thoughts with their partner, may not have openly talked about sex before. Common reasons people may avoid talking about sex include: embarrassment; lack of time or privacy; lack of confidence or fear of rejection; fear of getting cancer; waiting for the other person to mention it; and assuming that things are back to normal.
It can seem easier to avoid talking about sex when you are both coping with the demands of cancer and treatment, but this often leads to frustration and confusion, as neither of you will feel like you are having your needs met. Let your partner know what you’re going through and how they can help you cope. It may help to talk about how your relationship is changing and that you both need time to adjust.
Sometimes it’s better to have these talks outside the bedroom. To avoid any confusion or feelings of pressure, consider talking about sex at a time when you aren’t usually going to be having sex.
It can also help to set aside time for other types of intimacy. Plan to have a regular meal together or go for a walk. Try to focus on sensual activities that don’t involve penetrative sex, such as hugging, skin-to-skin contact or massage. If you need support talking to each other, consider counselling – call Cancer Council 13 11 20 or ask your doctor or nurse how to find a counsellor in your area.
How to start a conversation about sex
It’s hard to know what to say or how to begin a conversation sometimes. Even if these suggestions don’t fit your situation, they might give you a starting point.
- “I feel like I never have any energy for sex, but I’m worried about how you’re feeling about that. Maybe we can work out a plan together.”
- “I am going to show you the way I like to be touched and the places that are sore and out of bounds.”
- “I feel ready for sex again, but I’d like to take things slowly.”
- “I’m ready to cuddle, but worried you think I’m ready for sex – can we agree to just cuddle for now?”
- “There are some things I would like to try to do together that may help us feel close and connected, without ‘going all the way’.”
- “I really miss our sex life. When can we talk about being physically close again?”
- “That’s the right spot, but a lighter touch would feel good.”
Communicating with a new partner
You may be worried about starting a sexual relationship with someone new in the future. It isn’t easy to decide when to tell a potential sexual partner about any changes to your body (such as having a breast removed or breast reconstruction, or if you need assistance with erections or have a stoma). It’s natural to be worried about their reaction to seeing you naked for the first time. Likewise, you may feel concerned about explaining any issues with fertility, especially if you had cancer when you were young.
Take your time and, when you feel ready, let a new partner know how cancer has changed your body. It may be easier if you practise what you want to say with someone. Think about answers to any questions they may have. Start with small amounts of information and provide further details if they ask. Before any sexual activity, you may want to show the other person how your body has changed, so you can both get used to how it makes you feel.
How to start a conversation about sex
It’s hard to know what to say or how to begin a conversation sometimes. Even if these suggestions don’t fit your situation, they might give you a starting point.
- “The cancer treatment changed my body in different ways. It’s hard to talk about the changes, but I want you to know about them. The treatment left me with [a stoma/erection problems/etc.].”
- “I really like where our relationship is going. I need you to know that I had cancer some years ago, but I’m afraid you might prefer to be with someone who hasn’t had cancer. What are your thoughts about it?”
- “I am still interested in sex, but we might have to be a little inventive.”
- “I haven’t had sex since my cancer treatment, and I’m worried about how things will go. How do you feel about taking things slowly?”
- “Before we get really serious, I want to let you know how cancer treatment affected my fertility. I can’t physically conceive children, but I’m willing to explore other ways of becoming a parent down the track.”
If you’re a young adult
During and after cancer treatment, young people need to continue to develop and mature. This means living as normal a life as possible, which might include going on dates or having a partner. These activities can feel especially challenging if you are dealing with changes to how you look or fertility issues, or if you feel you haven’t had much experience of sex with someone.
As well as talking to your treatment team and possibly seeing a sex therapist, you could get in touch with Canteen. They offer counselling in person or over the phone 1800 835 932, via email or direct message (DM). Canteen also runs online forums and camps.
Featured resource
This information is reviewed by
This information was last reviewed August 2022 by the following expert content reviewers: Dr Margaret McGrath, Head of Discipline: Occupational Therapy, Sydney School of Health Sciences, The University of Sydney, NSW; Yvette Adams, Consumer; Dr Kimberley Allison, Out with Cancer study, Western Sydney University, NSW; Andreea Ardeleanu, Mental Health Accredited Social Worker, Cancer Counselling Service, Canberra Health Service, ACT; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Dr Kerrie Clover, Senior Clinical Psychologist, Psycho-Oncology Service, Calvary Mater Newcastle, NSW; Maree Grier, Senior Clinical Psychologist, Royal Brisbane and Women’s Hospital, QLD; Mark Jenkin, Consumer; Bronwyn Jennings, Gynaecology Oncology Clinical Nurse Consultant, Mater Health, QLD; Dr Rosalie Power, Out with Cancer study, Western Sydney University, NSW; Dr Margaret Redelman OAM, Medical Practitioner and Clinical Psychosexual Therapist, Sydney, NSW; Kerry Santoro, Prostate Cancer Specialist Nurse Consultant, Southern Adelaide Local Health Network, SA; Simone Sheridan, Sexual Health Nurse Consultant, Sexual Health Services – Austin Health, Royal Talbot Rehabilitation Centre, VIC; Prof Jane Ussher, Chair, Women’s Heath Psychology and Chief Investigator, Out with Cancer study, Western Sydney University, NSW; Paula Watt, Clinical Psychologist, WOMEN Centre, WA.