Cancer, Sex, & Intimacy

Cancer, Sex, & Intimacy

Cancer isn’t pretty. Besides generally feeling unwell, the hair loss, body composition changes, aches and pains, and hormonal fluctuations are not exactly sexy. Having cancer (or loving someone who does) can certainly challenge intimate relationships. It’s important for cancer warriors to know this isn’t unusual and there are plenty of ways to maintain healthy relationships with their partners ❤

Some cancer- or treatment-related challenges that may affect someone’s sexual function, sexuality, or intimacy with their partner can include:

  • Chemo side effects including fatigue, nausea/vomiting, weight loss/gain, or infertility concerns (etc, etc, etc….)
  • Post-surgical or post-radiation considerations like:
    • pain or restrictions from scar tissue or irradiated tissues (especially with cancer of the reproductive organs)
    • decreased sensation around the nipples after mastectomy
    • urinary incontinence or erectile dysfunction post-prostatectomy
  • New medications that reduce desire or arousal
  • Hormonal changes resulting in low libido, vaginal dryness, or painful sex
  • Body image concerns including attractiveness to self or partner
  • Depression, anxiety, or PTSD surrounding a cancer diagnosis and treatment

There are many ways that pelvic floor physical therapists (PFPTs) can help support both men and women during and after cancer in this realm. PFPTs can treat the physical changes that come with cancer including post-surgical rehab or prescribe general strength/aerobic training. We can treat incontinence after surgery or radiation. We can recommend sexual positions or devices to reduce or eliminate pain with sex. And sometimes, we help our patients find new ways to connect with their partners when they’re not ready to be sexually intimate yet.

Often, seeing a licensed counselor or psychologist for individual and/or couples therapy can be very helpful to maintain or restore intimacy. Remember, cancer is not pretty, and there is no shame in asking for help! If you’re having concerns or challenges in your relationship, please reach out to me to see if pelvic floor PT or a referral to a mental health professional might be right for you.

Aloha ❤

*This blog is part 3 of Pink October’s Pelvic Floor Series, a way to raise awareness of pelvic floor problems during cancer treatment and discuss sex & intimacy after a cancer diagnosis.

Cancer & Pelvic Pain Conditions

Cancer & Pelvic Pain Conditions

On today’s blog, I wanted to bring attention to female pelvic pain and dyspareunia (pain with intercourse) secondary to cancer treatments.

Often, when a woman has gone through adjuvant hormonal treatments, chemotherapy, abdominal/pelvic radiation, or fertility-saving drugs during active treatment, the body goes into a state of menopause or “chemopause” as it’s commonly referred to in the cancer world.

Low estrogen levels during chemopause can cause symptoms like:

  • Amenorrhea (loss of menstrual cycle)
  • Low libido
  • Vaginal dryness or atrophy
  • Hot flashes
  • Mood changes
  • Joint aches and pains

In particular, vaginal dryness or atrophy can have a huge impact on sexual health, emotional health, and relationships post-cancer. If the pelvic floor muscles are compromised by treatment, it can result in pelvic pain (like pain from overactive or tight pelvic floor muscles, pain in the tailbone, lower abdominal pain, or pain around post-surgical scars), bladder/bowel changes, or painful sex.

Thankfully, a pelvic floor physical therapist with specialized training in examination and treatment of the pelvic floor muscles can treat these conditions and are an amazing asset to oncology patients on their road to recovery. Some PT treatments for pelvic pain and dyspareunia may involve:

  • Pelvic floor muscle strengthening or relaxation exercises with or without biofeedback training (computer or ultrasound-based pelvic floor training technology)
  • Stretches for tight muscles around the abdomen, pelvis or hips
  • Manual therapy including general massage, pelvic floor muscle release techniques, or scar tissue mobilization
  • Education and lifestyle strategies surrounding posture, nutrition, bowel and bladder habits, and lubrication options during intercourse
  • Education in the use of vaginal dilators to reduce pain that occurs with tampon insertion, gynecological exams, or sex
  • Encouragement around body image and sexual health (this could include referral to a sex therapist or psychologist when appropriate)

If you’re reading this, and you feel like you could benefit from pelvic floor physical therapy during or after cancer treatment, you can find a qualified pelvic floor PT in your area here or here. Ask your doctor for a referral today!

And a quick reminder for all of us…
The path to recovery from cancer involves a whole host of treatments including chemo, hormonal treatments, surgery, and radiation just to name a few. Each of these treatments can come with significant side effects or long-lasting comorbidities. Just because someone is “cured” from cancer doesn’t always mean they are living without long-term effects from treatment. Keep this in mind, and be kind!

*This blog is part 2 of Pink October’s Pelvic Floor Series, a way to raise awareness of pelvic floor problems during cancer treatment and discuss sex & intimacy after a cancer diagnosis.

Aloha ❤