Sex can be a sensitive subject for people under ordinary circumstances, let alone after a cancer diagnosis. Many people who have had bowel cancer find that they have problems with both lack of interest in sex and performance as a consequence of their diagnosis and treatment.
There is also the potential for difficulties and anxiety around intimate relationships and sexual intercourse which, if not addressed early, can undermine your recovery and this may lead to other problems with personal relationships.
There may be physical issues such as lack of energy, physical discomfort after surgery, and/or the fear that you may do more harm than good! There may also be more complex psychological problems that can affect how you feel about initiating sexual activity.
Talking to your partner about how you might still be able to enjoy an intimate relationship without full intercourse may help, if this is a problem for either of you. You can have fun making small changes to favourite positions or finding other ways of giving pleasure without putting pressure on newly healing wounds or a stoma. Experimenting with low lighting and keeping on some clothing may also help, if you are self-conscious about scars, a stoma or unpredictable leaks.
Surgery, some chemotherapy drugs and radiotherapy can affect the tiny nerve endings and blood vessels around the pelvis, causing local inflammation and swelling, changing the sensations you can feel. This is often only a temporary problem that will gradually settle down, but occasionally there may be some longer-term loss of sensitivity or numbness in and around the pelvis and genital area.
Advice for men
As a result of surgery or radiotherapy, you might find that you are having problems achieving or keeping an erection. This is again much more common than you might expect, and happens as a result of inflammation and damage to tiny nerve endings and blood vessels in the area around the pelvis. These side-effects of treatment are often short-lived and gradually disappear over the course of a few weeks or months, but occasionally it can become something that remains a problem.
Almost half of all men who have had treatment for bowel cancer find that they have problems associated with both interest in sex and performance as a consequence of their diagnosis and treatment, so you are not alone. If you experience long-term difficulties or have concerns about intimate issues, there are things that can be done to help, with the support of your GP, specialist nurse, or a genito-urinary specialist or psycho-sexual therapist.
There are medications, and other techniques that can help to strengthen and sustain an erection, and many practical tips and advice to help cope with these new challenges and find new ways to achieve satisfaction and intimacy with your partner.
Advice for women
Almost half of all women who have had treatment for bowel cancer find that they have problems associated with both intimacy and sex as a consequence of their diagnosis and treatment. Being self-conscious about how your body looks after surgery (with or without a stoma) is only natural and there may be practical reasons such as low energy levels and discomfort from scar tissue that can affect how you feel about wanting to have sex.
If you have had radiotherapy, there is an increased risk of vaginal dryness and tightening, which can make penetration and vaginal examinations uncomfortable or painful. This can be eased in a number of ways, by using intimate lubricating gels or creams to help moisten the vagina and gently massaging the area with your finger to keep it supple. Natural lubricants, such as ‘Sylk’ or ‘Yes’, are available on NHS prescription. Using vaginal dilators, which are also available on NHS prescription, can help prevent tight bands of scar tissue forming, and keep the vagina ‘open’ after your treatment has finished.
There is specialist help available if you need it from gynaecologists, genito-urinary specialists or psycho-sexual therapists, to talk through worries or to help find solutions to practical problems or concerns. Your GP or specialist nurse can make the referral for you.
More information from: Sexual Advice Association
T: 020 7486 7262