Can We Talk About Sex... and Cancer?

We all know that cancer changes a person forever. It clearly changes us physically. It also changes us emotionally. Now here's the part no one really tells you: Cancer really does a number on your sexuality, especially us women.
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Anyone who knows me knows I'm not shy about talking about much of anything, especially sex. Although I'm happily married and in a monogamous relationship (in which I plan to stay for the rest of my days), I've been in relationships with both men and women and had my share of experiences during my 45 years. I'm an open-minded, sexual being.

In addition, I've worked for more than 22 years in family law. There's not much of anything I haven't heard when it comes to sex, and I'm rarely ever shocked. I'm the friend to whom you can talk about sexual positions, weird infections, unique fetishes and favorite toys. I have lots of great stories to tell (mostly about myself). I listen without judgment and can find the humor in pretty much anything.

So why, then, has it been so difficult for me to talk about sex as it relates to cancer?

Apparently, I'm not alone. When searching the Internet and other cancer resources for frank discussion about sex and cancer, the pickins are pretty slim.

There seems to be a level of shame around these combined subjects. And even though I don't fully understand it, I feel it too... to the point that this topic is probably the most difficult about which I've written since my diagnosis.

We all know that cancer changes a person forever. It clearly changes us physically. We have scars, missing body parts and debilitating side effects of treatment. Some of us lose our hair, eyelashes, eyebrows and even fingernails. Sometimes these features grow back; sometimes they don't. Sometimes they grow back but in strange and different ways. Sometimes treatment ages us. Some of us become bloated from steroids; some of us become emaciated from chronic nausea. In myriad ways, cancer very often changes the way we look.

Cancer also changes us emotionally. We are different people after an experience with cancer. We look at life through a different lens than before cancer. We often have different values and priorities, post-cancer. We have a better appreciation for life and relationships. We have less time for pettiness and often become more goal-oriented. And more than a few of us have a bit of "Cancer PTSD," living in constant fear of recurrence. We're simply not the same people we were before our diagnoses.

Now here's the part no one really tells you: Cancer really does a number on your sexuality, especially us women. Not only do new body image issues often arise as a result of the scars and missing body parts and weight changes, but sexual changes occur as well. For some of us, sexual intercourse is now painful as a result of vaginal stenosis (where the vaginal canal actually narrows due to scar tissue). It is also quite common to experience reduced sex drive and vaginal dryness due to hormonal changes. Not to mention the fact that we're often fatigued and emotionally drained.

Cancer can make one feel decidedly unsexy.

And talk about piling on. Do we really need this on top of everything else? We already feel guilty for the amount of space cancer has taken up in our daily lives, and for putting our partners and significant others through their own trauma as a result of our diagnosis and treatment. Now they get to be deprived sexually as well?

My sexual recovery time was something not really discussed on the front end, but was a very real part of the aftermath of my diagnosis and treatment. I had to recover from a C-section, then a radical hysterectomy and cancer surgery, then 24 rounds of chemotherapy. And just when I started to get some of my sexy back, I learned I was BRCA1 positive. I'm now slated for a prophylactic bilateral mastectomy in a couple of months.

I'll be sad to lose my breasts; but even more sad, I think, to lose my nipples. Nipples aren't just for looks, you know. This is going to be just one more way in which my sex drive is impacted.

Now, this may sound like a pity party, but it's not. I simply want this admittedly uncomfortable topic to be part of the conversation. I want our partners and significant others to know that it's really not them, it's us; and it's largely temporary. While we may never get back our naturally produced hormones and our female reproductive organs and our breasts, and while we may be different women than we were when you met us, we are still women. We are sexual beings and we love you, probably now more than ever.

The truth is that our brains are our largest sex organs. And, if we're lucky, we still have our five senses with which to see, hear, touch, smell and taste you. We might have to work a little harder to get there, but we'll get there -- and get you there -- one way or another.

And isn't getting there at least half the fun?

Did cancer impact your sex life? If so, how? Please share your experiences in the comments below.

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