Great Sex After Cancer

You Are Not Alone in Coping with Sexual Dysfunction

Millions of men and women experience sexual dysfunction caused by illnesses that affect them or their spouses or partners. Consider these shocking facts:

• Half of all American men over 40 are struggling with some form of erectile dysfunction (ED).

• 40% of American women experience female sexual dysfunction.

• Half of all men over 50 have an enlarged prostate that can block sexual functions.

• One in eight women eventually get breast cancer.

• One in six men eventually get prostate cancer.

• Prostate cancer treatment results in ED for 50% to 75% of survivors.

• 55% of women don’t talk to doctors, especially about bladder or sexual problems; men also avoid such personal discussions - and so do doctors!

At best, sexual dysfunction can make a man feel “less of a man,” and a woman feel “less of a woman.” It deprives you of carefree intimacy and can ultimately destroy your close relationships. Don't lose hope - there are many ways to deal with the challenges for sexual dysfunction both medically and emotionally. Check the resources available on this website and get my free report, Renewing Intimacy after Illness.

 

Humor and Private Space Can Help Couples Cope with Intimacy Issues

Physical changes, emotional distress, and lingering side effects from cancer treatment can all get in the way of intimacy and sex after cancer, impairing a couple’s affection for each other. Still, while it may be difficult, it’s not impossible to lighten up with a smile.

In that regard I’m a strong advocate of playfully expressing whatever actual or perceived rifts you feel. I stress this as one treatment modality when counseling couples. Do your best to tell each other humorous anecdotes that can create mutual understanding. Try it! It might be just the right step to start bringing you back together.

The following two humorous stories illustrate how to keep a marriage or other ongoing relationships strong by giving each sufficient “space.”  This is helpful especially during short or long periods of disaffection. Once cancer treatment side effects abate, humor can help further your chances of renewing intimacy.

Putting this in a broader context, we need to recall that strained relationships are not caused only by cancer and its treatment side effects. Intimacy can be endangered by a host of day-to-day tensions. In either case humor can offer couples the perspective they need to get through the hurdles that confront them.

Take for instance a man who was married for 50 years…to the same woman!  Newspaper reporters who interviewed him on his golden anniversary asked him how he and his wife managed to sustain their relationship in an era where half of all marriages end up in divorce.

“Easy,” he replied. “As long as we’ve been married, we’ve gone dancing every week. She goes dancing every Monday, Wednesday and Friday, and I go dancing every Tuesday, Thursday and Saturday!”

Sex and Cancer – How to Reignite the Sparks

Sex and cancer is an important issue for many of us who have survived prostate or breast cancer or other illness accompanied by adverse treatment side effects. Such concerns affect millions of men and women.

When it comes to reigniting intimacy and sex, those of us who have had cancer require our own unique solutions. However, we can also draw on general sexual literature for answers to pressing intimacy concerns. After all, a number of sexuality professionals have important things to say to all couples, whether or not an illness was a primary cause of our particular sexual dysfunction.

Along these lines I would like to share a recent blog post by my friend and colleague, Sheri Winston, author of Women’s Anatomy of Arousal: Secret Maps to Buried Pleasure.

I met Sheri in May of 2011 at the annual meeting of AASECT - the American Association of Sexuality Educators, Counselors and Therapists. At our conference, she led a presentation about women’s anatomy, clarifying that ounce-for-ounce, inch-for-inch, women have the same erectile tissue of men throughout their bodies. Of course much of men’s external erectile tissue is inverted in women – that is, it’s on the inside. In that regard women and men mirror each other anatomically. But that’s a topic we can delve into further another time.

Like her conference presentation, Sheri’s blog comments tend to be informative, direct, and passionate. For instance in one of her recent posts she offers hints for reigniting intimacy in marriages and other long-term relationships. Citing statistics that after four years many couple’s initial passion begins to wane, she pinpoints how to reverse that process.

I’ll mention just three of her main points, which I’ll paraphrase here:

• Don’t kiss your partner in a perfunctory manner, with a peck on the lips or cheek. Kiss him or her passionately like you mean it, and don’t shy away from using a wet kiss!

• Don’t simply look at each other. Instead look deeply into each other’s eyes, with all the passion you had during your courtship and earliest years together.

• During your quieter moments as a couple try to breathe in synch, so the flames of your love can well up again.

In my view consciously breathing in and out together can really help couples grow their love and even blow their minds. As air sucked into a bellows gets expelled to enlarge a blacksmith's flames, breathing in and out in unison in a sustained way can work wonders for reigniting many folks' dwindling sparks of intimacy and sexuality! It is one of many ways to help each of you become one again.

Spending a few moments in solitude, looking deeply into each other’s eyes can also be quite impactful. Perhaps this is why tantric tradition regards eye-gazing as a core practice, enabling two people to plummet their soul mate’s soul. If you try this when you are alone with your beloved, you may well find that it can reinforce the bond between you.

These and many other personal practices can help you reignite the flame of love. This is so whether or not you’ve endured cancer, as long as you have (or hope to have) someone “special” in your life.

Even when ill health reduces your passion for your significant other, taking small but tangible steps to reignite your love life will do you both a world of good.

To learn more about how to reignite the passion in your relationship, see my home study course, 10 Strategies for Reigniting Intimacy and Sex After Cancer.

 

Great Sex after Cancer and Other Major Illnesses

Each autumn, slogans like “Choose blue!” or “Think pink!” abound, along with blue or pink newspaper and magazine sections, advertisements and supermarket products. These announce the annual advent of National Prostate and Breast Cancer Awareness Months every September and October. However, an important issue is often overlooked at this season.

I appreciate the positive emphasis on the need for medical research and community support. But as a prostate cancer survivor, healthcare educator, and certified sexuality counselor with a doctorate in gerontology, I'm concerned that hardly anyone stresses ways to address cancer survivors’ need for greater intimacy, even though most suffer from some form of long-term sexual dysfunction.

In fact, one-third of the 400,000 Americans diagnosed each year with prostate or breast cancers are Boomers, ages 45 to 65, whose vibrant personal lives are suddenly disrupted.

When it comes to major illnesses like breast and prostate cancer, quality of life issues like improving patients’ sexual relationships are generally overlooked, even when specialists address the medical mechanics of sexual rehabilitation.

To help patients, survivors and their partners resolve their most intimate concerns, I have created the Intimacy Development System (IDS), offering ten strategies to reverse survivors’ tendency to distance themselves from their spouses or partners due to anxiety about disfigurement or sexual dysfunction.

The most crucial strategy is to “make love,” and not just “have sex.”  Intimacy can develop if partners emphasize “whole-body sex” rather than intercourse alone. I recommend the “S-T-I-C-K” method of sensate-focus, where partners express mutual appreciation and rekindle romance through psychological stroking (S), touching (T) from head to toe, intercourse (I) only if mutually desired, cuddling (C) and kissing (K). Initiating humor and playfulness and “keeping the faith” are equally important.

Learn about these and other helpful techniques in my free report, Renewing Intimacy after Illness, and my new ebook, Reigniting Intimacy and Sexuality after You're Ill. You'll find even more tips in my home-study intimacy course and in my Amazon bestseller, Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life. 

Case Study - When Men Avoid Sex After Cancer

Sexual intimacy is on the minds of many women whose husbands undergo prostate cancer treatment such as surgery, radiation or hormone therapy. That is not surprising since about half of all men who are subjected to prostate cancer treatment suffer afterwards (if not before) with ED and often with the loss of libido. Many women have sought ways to get their husbands to consider recharging their sexual relationship and emotional intimacy. I’ve summarized this below in a question-and-answer format.

Question: My husband’s sex drive since his prostate cancer surgery a year ago has come to a grinding halt. I’m at a loss because he no longer touches me when I reach out to him. He has a hard time responding to vaginal or oral sex and rarely kisses me.

I’ve done my best to tell him I love him and that we need help, but he continues to avoid the subject of sex. In short, his desire for intimacy with me, while great before the surgery, is now gone, as his ability to have an erection. He refuses to see any professional counselor or read educational or support material including what you offer. I’m wondering if his disinterest will force me to remain celibate from here on. What can I do?  

Answer: I've been there and done that: withdrawing emotionally and physically from the person who matters to me most, to wit, my wife. Like your husband I did this for about a year and longer after prostate cancer surgery. Like him I felt that even with nerve-sparing, intense ED made me less than a man, and besides, my libido was nil due to biochemical castration with my testosterone levels down to 8 ng/dl, when low normal starts at 240 to 300 ng/dl (nanograms per deciliter of blood).

What helped arouse my libido was the realization that I could go above castrate level only by seeking testosterone replacement therapy. With that in mind I urged my surgeon to prescribe synthetic testosterone. 

About two years after my robotic surgery my doc told me I was a "poster boy" for TRT (testosterone replacement therapy), by virtue of still having an undetectable PSA. At that point he gave me a prescription for testosterone replacement medication. He preferred that to other methods of supplying testosterone, such as injections. He told me it would not only improve my sexual functioning, but help promote a sense of well-being, muscle maintenance, bone growth, and a sufficient level of red blood cells.

Within 6 months my testosterone level climbed and went above  the low normal range, reaching 360 ng/dl (the normal range is generally regarded as 240 or 300 to 1200 ng/dl). My libido came back increasingly stronger without some of the side effects testosterone can cause.

Perhaps armed with my experience or those with a similar tale, you and your husband could arrange to talk with his medical doctor, as opposed to a counselor or sex therapist, which your husband evidently won’t see right now. Your husband (or you initially, if he's not easily convinced) could inquire about following the same path, which will perhaps work for him as it has for me.

But please note: ED for me remains a problem, so I've had to develop my own brand of sensate focus, that is, emphasizing sensuality that engages different body parts (mine and my wife’s) in what I call "whole-body sex."  This has allowed us to broaden what we mean when referring to sexuality, and shifting to this outlook has renewed and deepened the emotional intimacy we enjoy.

I’d go a step further to indicate that our sexual interaction in some ways is qualitatively better than it was what before the surgery. But as most men can concede after prostate cancer treatment, even when sex gets better, it's never the same as it once was. 

Sex and Cancer - What Men Can Do About Low Libido

Many men suffer from low libido after cancer treatment. This topic was featured recently on the highly rated online radio show,Wellness for the Real World, hosted by the vivacious Dr. Veronica Anderson.

I was the second of five panelists invited to speak. I spoke primarily about how to overcome a low libido after  cancer or other serious illnesses that impact many cancer survivors and their signficant  others. 

You can listen to the entertaining and informative show here.

Once you hear the show, and even if you don’t, feel free to share your views and experiences on this vital topic. You can state your thoughts with total anonymity here at this blog by leaving a comment in the space below. We never reveal the names of those who write us.

Treatment Options for Low Libido, E.D. and Low Testosterone

After experiencing ED, a low libido and/or a low testosterone level due to cancer treatment or other health issues, men and women alike often ask whether Viagra or testosterone cream can really help restore sexual function to enhance intimacy.

A number of men have reported it takes one to two years after treatments like robotic surgery for prostate cancer to achieve an erection with Viagra or comparable meds. In my case it took three years, so patience is needed.

However after my surgery in April 2007 it took just two months to effectively use a a vacuum erection device or VED. But I found it caused delays, literally left me cold, and had a "hinge effect", which frankly unhinged me!

My underlying problem, as I knew from the get-go, was an extremely low testosterone level, due to unnecessary hormone treatment, problems like diabetes and peripheral neurpathy, and mild depression. On top of that my libido went way down because of all the meds I was on.

My low testosterone level was demonstrated by a simple blood test. After waiting two years after surgery to confirm an undetectable PSA score, my doc prescribed testosterone cream from a compounding pharmacy a few miles from my home. I willingly paid about $200 every three months for the T-cream, since it restores libido, improves well-being and enhances overall body toning. I’m convinced that is what made my use of Viagra even more effective.

Recently I verified that Women's International Pharmacy, located in Wisconsin and Arizona, also makes  compounded testosterone, but it costs only $47 for a 3-month period. This is a great resource for the money. While I get no commission from them, I encourage you to check them out on Google.

This pharmacy also compounds DHEA (dehydroepiandrosterone) for women who are at a sexual low-ebb, although DHEA is now available as an over-the-counter tablet in most pharmacies. Doctor-supervised DHEA, a precursor to male and female sex hormones (androgens and estrogens), is recommended by Dr. Laura Berman of Chicago and the Mayo Clinic. However, there are no studies on its long-term effects.  

A few others have told me that Women's International Pharmacy, which is strictly "made-in-the-USA", is quite reliable and inexpensive. But bear in mind that it only dispenses compounded meds after your doctor sends them a prescription.

The bottom line: If you find you are at a low ebb, you would do well to use all the pharmaceutical resources at your disposal. Even if you do, waiting for renewed sexual function can take awhile. But better late than never!    

Sex and Friendships

Cancer treatment side effects, such as ED and a reduced libido, may decrease or even eliminate a man's ability to have sexual intercourse, but friendships help soften the blow.

 Let's face it, sex is not the only way to get your endorphins to kick in. And friendships offer one path among many to get out of the doldrums after prostate cancer treatment and reach a "natural high." As another blogger wrote a few months ago in regard to most folks (whether or not prostate cancer has occurred), there's a host of wonderful activities that offer the benefits of sex, when intercourse is no longer possible, or for that matter, when Viagra or other ED pills or devices work at least on occasion, but you don't have a sexual partner for that occasional "afternoon delight."

The list includes self-loving  (masturbation), although self-stimulation may be a more precise phrase as it can be part of broader self-loving (versus self-hating). Then too there's massage, yoga, and aromatherapy - which are also great stress relievers. Close family ties and friendships where hugging and laughing are experienced, as well as exercise, spiritual routines, and what some have called "natural therapies" are additional ways to "rev up your motor" and sublimate your sexual needs.

In my view forming friendships needs to be the “first order of business”, whether or not a person has a sex partner, since close friendships can provide some physical and emotional benefits that parallel the emotional and physical outcomes of sex. 

To elaborate, endorphins often flow when you have close relatives and friends. A joyful sense of being together with people who have a lot in common with you can serve you well. Simply pursuing activites with friends, whether conversing, going to the theater, helping each other find a job, etc., can reduce pain  and stress.

It's important to emphasize why that occurs. I believe it’s because you know someone is there for you - someone you can trust and who can trust you as well. Most of us can get an emotional high by confirming each other's doubts, defeats and victories, and going the extra mile for each other.

This delightful dynamic is feasible even in perfectly platonic relationships.