Myth Busting: Sex and Cancer

If you are struggling with sexual intimacy after cancer, you are not alone. In fact, most people who’ve experienced cancer report that sexual functioning and/or satisfaction have been impacted to some degree.

Many of the challenges people face when navigating sex after cancer are based on assumptions and expectations about how sex “should” be. Here are four common myths that can get in the way of reclaiming your sex life after cancer along with some myth busters and tips to support sexual re-connection.

Myth 1: Sex will and MUST go back to “normal”

This common myth puts an incredible about of pressure on individuals and couples living with and beyond cancer. The truth is, sex typically does change as a result of cancer and treatment, at least to some degree. Some of these changes are temporary and others may be permanent. The expectation and pressure for sex to be the same as it was before cancer make the discomfort and distress associated with these changes feel even worse, and can lead to feelings of hopelessness, frustration, and resentment. Hanging on to this myth also gets in the way of seeking support and discovering new experiences.

Myth Buster: Accepting that things are going to be different

The reality is that our sex lives are constantly evolving, who we are as a sexual person changes over the years, and our definition of what is “normal” evolves as a result of time, age, experience, and life transitions. Acceptance doesn’t mean saying that everything is okay. It also doesn’t mean that you agree with the change or that you don’t want things to change in the future. Acceptance simply means assessing the situation for what it is and developing realistic expectations. Acceptance also means allowing yourself to make room for feelings of grief and sadness at the loss of your sense of self as a sexual person (this can include loss of body, loss of certain sexual activities, loss of identity). It’s ok to be sad and miss these things. While it may seem counter intuitive, accepting that things are different instead of fighting what can’t be changed opens you up to a whole set of possibilities and problem solving by freeing up mental energy to identify what can be changed and fostering resilience and creativity. Acknowledging things as they are in this moment can open the door to new (and even better) ways of being sexual.

Myth 2: Different means worse

Remember that you are in new territory here. The landscape is different: your body is different, your relationship dynamic may have shifted; emotionally, you and your partner(s) probably feel different. It’s important to acknowledge that yes, sex will be different, but this doesn’t mean it can’t be as good or possibly even better than before. A first step to busting this myth is to shift your thinking from “I will never be the same again” to “life will be different, and I have the resources I need to find new ways of satisfaction.”

Myth Buster: Be open, have patience, and stay persistence

Be flexible and open to new experiences, but don’t feel pressured to re-invent the wheel. Think about what you enjoy and find pleasurable, and consider ways of modifying this. This can include using aids (e.g. pillows) to make some sexual positions more accessible; wearing clothing or keeping the lights low if you aren’t comfortable being seen by your partner yet; and adding lube and toys to your sexual repertoire if you haven’t already. When it comes to finding your way back to each other, simplicity and comfort are key.

Get creative! Allow yourself to experiment with new sexual/sensual experiences and ways of being physical. Try things a few times even when they feel new or awkward, and don’t give up because something didn’t work the first time. Adapting to changes may require you to develop more openness and confidence, both in and out of the boudoir, but it will be worth it in the end.

Communication is the bridge back to sex, so it’s important to talk about your needs, concerns, comfort levels, and boundaries. It is also important to communicate during sex when something doesn’t feel good AND when something does. While talking about sex can feel awkward, it helps both partners feel safe and supported. Talking about sex is also a good way to feel connected without having sex…you may even discover something new about each other along with a new set of sexual possibilities!

Myth 3: Sex will spontaneously and effortlessly resume

Going through cancer and treatment takes a lot of physical, emotional, and mental energy. It should come as no surprise that sex can take a back seat as you focus on your treatment and recovery. Many couples assume that with time they will seamlessly fall back into their natural sexual rhythm. But time is usually not enough. It’s what we do with this time that counts. Waiting around for sex to pick back up on its own, or assuming that eventually one partner will initiate when ready and/or interested can lead to disappointment, frustration, and loneliness. Think about it: If you are an avid runner who breaks an ankle, you will likely be out of commission for a while. Time alone will not fix your ankle; you need to work at it and gradually build yourself back up to running. You may even have a little hesitation or feel off your game. Sex after cancer is no different.

Myth Buster: Get back to basics

Emotional intimacy and sexual intimacy are intertwined and influence one another. Not being sexually intimate can impact your emotional connection; likewise, deepening your emotional connection can make it easier to find your way back to each other sexually. Find ways to connect and feel close…go on a date, start a new activity together, make an active effort to spend more time together, learn new things about other. This can be especially important if you have found yourself in a patient-caregiver dynamic during treatment. Take pleasure in getting reacquainted each other as romantic and sexual partners. Let yourself ease back into sex.

Myth Buster: Scheduling sex

I know, I know. Scheduling sex sounds so unsexy. That’s because we receive constant messaging that sex needs to be spontaneous in order to be good or special. As a result, couples often express concern that scheduling sex will take the fun out of it and make sex boring. But life gets busy…work, family, appointments, responsibilities, and the general daily grind can make it hard to find the time, energy, and desire to have sex. You may find yourself leaning too much into the chill side of “Netflix and Chill.” This is why scheduling sex is so important. Sex doesn’t need to be spontaneous to be great!!! Think of scheduling sex as prioritizing your relationship. Scheduling sex sends a message of commitment and intention; the anticipation of sex can also create a buildup of sexual energy. Scheduling sex can even increase your desire in the long run, which then opens up the possibility for more spontaneous sex!

Myth 4: If we aren’t having sex, physical affection is also off limits

May couples report having less or no sex from the time of cancer diagnosis and through treatment. Unfortunately, many also report that when sex has stopped, other forms of physical affection dwindle as well. Fear of making the other person feel bad is a common driving force in the avoidance of physical affection. Partners may shy away from physical affection to avoid making the other feel pressured to have sex, to avoid creating hope or expectation for sex and having to turn a partner down, or to avoid being rejected. The problem with this myth is that it can leave both partners feeling distant and alone in the relationship. Just because you aren’t having sex doesn’t mean you can’t be physically affectionate. By the same token, don’t assume that physical affection has to lead to sex.

Myth Buster: Physical affection strengthens connection and can even be good for your health

There is no reason why you can’t still feel physically close to your partner if you aren’t having sex. In fact, physical intimacy can be especially important when you aren’t having sex because it maintains feelings of closeness and emotional intimacy. Physical intimacy includes things like kissing, hugging, cuddling, massages, taking a bath or shower together, slow dancing, holding hands, a spicy make out session, etc. When you engage in physical touch, your body releases oxytocin, often referred to as the “love hormone,” which increases feelings of trust, closeness and connection between partners. Physical intimacy has also been linked to various health benefits like lower cortisol levels, enhanced immune function, as well as stress and pain relief. While expressing physical affection doesn’t have to lead to sex, it can play an important role in finding your way back to each other as sexual partners. Talking about your expectations and boundaries related to sex helps to take away the pressure to be sexual, allowing you both to lean into and enjoy other expressions of physical affection and closeness.

While changes in your sexual relationship can be upsetting, and the uncertainty of how to reclaim your sexual life can feel overwhelming, assumptions and expectations about how sex “should” often add to the distress of navigating sex after cancer. Acknowledging that things are different, finding other ways to connect, and being intentional in carving out time together, combined with a dose of patience, flexibility, and creativity, create a path to sexual reconnection. Let yourself lean into some discomfort, and consider talking to a professional if you are finding it difficult to navigate sex after cancer need some extra support.

Dr. Kimberley Cullen is a registered Clinical and Health Psychologist working with individuals and couples at Laksman Doell Psychology. Dr. Cullen has a special interest in the relationship between self-identity and mental health, and how these can be impacted by significant life events, life transitions, and managing multiple roles in life. Dr. Cullen enjoys helping clients to explore existential question