Coping with sexual changes after cancer (cont'd)

A number of effective interventions are available to address sexual as well as relationship changes after cancer. Interventions may be tried individually or as a couple. However, for a more satisfying outcome, it is best to involve your partner. The majority of couple and sexual strategies are part of a learning process with a series of trial and error consisting of mutual adjustments accomplished mainly through communication.

Regarding sexual function changes of the erectile, vaginal and orgasm response, strategies may include PDE-5 inhibitors (Viagra ™, Levitra ™, Cialis ™), injections, vacuum devices or penile implants for erectile dysfunction and lubricators (short/long acting), vaginal dilators or hormonal gel/creams for vaginal dryness/atrophy. Problems in the orgasm response may be alleviated by the use of vibrators, pelvic muscle exercises (Kegels) and for premature ejaculation, the intake of an SSRI type of anti-depressant medication (Paxil ™, Prozac ™). Used in combination with the above, other strategies found particularly helpful by partners to increase sexual desire and arousal include the practice of sexual fantasy before and during sexual activities as well as the use of erotic literature (visual/written), sexual toys (vibrators) emphasizing sexual play and experimentation.

However, enhancing couple and sexual intimacy starts with setting aside or planning time together, an exercise often experienced by couples as a date night. Ideally, it may consist in a weekly 3-4hr block of time where partners are engaged in a relaxed, mutually enjoyable activity that may or not include sexual activities. Paramount to re-establishing couple and sexual intimacy is partners' willingness to re-connect on a non-sexual, intimate level and to expand their definition of sex to include non-performance focused sexual activities. For example, mutual sensual caressing or erotic massage alleviates the pressure of performance and allows for the learning of new, alternate sources of sexual pleasure. Other key ingredients to greater couple closeness may include partners' commitment to share sexual advances, engage in mutual disclosure and active listening of concerns, fears, especially about the changes in their sexual preferences and needs.

In conclusion, a number of treatment options are now available to address changes that may have affected you personally as well as your couple, sexual relationships. It is thus important to become educated about these interventions either by talking to your care team or by consulting available resources.