Posts Tagged ‘erectile dysfunction’
Sex and Intimacy after Cancer
If you or your partner has been diagnosed with cancer, what part does sexuality play in your quality of life? How will cancer treatment impact your sexuality — physically and emotionally? How do you cope with changes in function, libido, body image, and pain? How can you maintain intimacy in the face of these challenges?
“Sexuality is all about who you are as a man or a woman,” says Sage Bolte, MSW, LCSW, OSW-C, a renowned authority on sex and intimacy after cancer and an oncology counselor at Life with Cancer®, an Inova Health System service in northern Virginia. “It’s a critical part of your quality of life.” Sex and intimacy are key ways to affirm, “I’m alive, I’m human,” and of getting back what was important to you before cancer.
On March 11, 2008, the Leukemia and Lymphoma Society presented a teleconference with Bolte for 1,400 listeners. It was superb. Fortunately, the teleconference will be available as a transcript and MP3 recording sometime in April 2008 at www.lls.org/survivorship.
Forty to 100 percent of people with cancer will experience some form of change in sexual function, says Bolte, which can impact willingness to engage in sexual activity. However, she assures us, “Patience and techniques can help you regain a sense of sexual self and confidence.”
Although Bolte’s message was targeted at the special challenges of cancer, all of her suggestions also apply to living with any chronic or life-threatening illness, as well as the sexual challenges of aging itself. Here are some of her techniques for coping with specific problems:
Vaginal dryness and discomfort: Apply 100% vitamin E oil to the vaginal tissues and clitoris on a regular basis after showering, and use a water-based lubricant as needed during sex. Talk to your doctor about whether an estrogen ring or testosterone patch would be appropriate to regain moisture and restore elasticity of the vagina.
Erectile dysfunction: Tell your physician about this problem and have him/her look at all your medications. Have your testosterone levels checked. If you’re having a harder time maintaining an erection, try finding the positions that is most stimulating for you. Help your partner reach orgasm before intercourse. Devices for men that may help include penile pump; penile injections, suppositories, penile implant, penile rings. But if you’re on blood thinner or have low platelets, you need to consult with your physician before using any of these devices, because they might put you at risk. Viagra and similar medications are not recommended for men who have heart concerns or are taking blood pressure medications.
Pain and fatigue: After cancer treatment, the time of day that’s right for sex might change. If you’re too exhausted in evening, switch to morning or have a special lunch break. Take pain medication 30 to 60 minutes before activity. Get exercise, which can minimize fatigue and assist in decreasing some joint pain. “Remember that we can rest during sex,” says Bolte. “It’s not a marathon.”
Fear of rejection: Consider seeing a couples counselor or sex therapist. Often the problems of miscommunication, misinterpretation, and anxiety get in the way of your sexuality and intimacy. Work on your communication skills. (Note: I’ll be writing more on this topic in another post.)
Difficulties reconnecting with your partner: Communicate your own desires, ask for what you need, and ask your partner to communicate honestly, too. Be affectionate. Take it “slow and easy.” Take time to be together and to connect. Find other ways for both of you to have pleasure.
Redefine your expectations,” suggests Bolte. “Sometimes you can’t get back to the function you had prior to cancer, but that doesn’t mean it can’t be good or pleasurable.” Focus on touch, sensation, pleasurable feelings. Use sex toys. Engage in mutual masturbation. Read fantasy to each other. Touch yourself. Massage each other and cuddle.
“Take more time to get stimulated, talk yourself into sex,” Bolte recommends. Realize that instead of the physiological response coming first and driving the emotional response, it may need to be the other way around, a “mind thing first.” Schedule your sex time – plan it, think about it, fantasize, and work yourself up to the mental excitement that will stimulate the physical excitement.
Don’t let sex feel like pressure to perform. Sometimes practice just touching without the expectation of intercourse. Re-explore alone what feels good to your body now. “Start with self-pleasuring experiences,” says Bolte. “Your body has changed since treatment. You need to be comfortable touching yourself and knowing what feels good now.”
I applaud the Leukemia and Lymphoma Society for recognizing the importance of sexuality to people diagnosed with cancer and Sage Bolte for generously providing her expertise.
Tom, 55, “My wife had her first orgasm in six years”
Tom, age 55, wrote me a beautiful account of how he and his wife rediscovered their intimacy and sexual pleasure after a combination of health issues and medications left his wife unable to have orgasms. She was taking blood pressure medicine and antidepressants, and had stopped hormone replacement therapy. Tom had his own health issues, including low metabolism and testosterone levels. Combined with his wife’s lack of lubrication, decreased sensation, and anxiety, “our sex life seemed to be drying up.”
We slowly reached the point where we decided we needed to fix the situation. We started taking more time in our lovemaking and trying different lubricants, and that did work much better for us. I also bought your book Better Than I ever Expected, and it has been very helpful.
However, I found that when we had romantic weekends, I would occasionally have problems maintaining my erection. That had never happened before and was really stressful, so I now use Levitra to have confidence that I can be erect. The effects of Levitra seem to linger, so I don’t feel like I need to take it right before lovemaking. I can take it anywhere from one to 12 hours ahead of time and it still works for me.
Unfortunately, no amount of foreplay, oral or manual stimulation was able to bring about an orgasm in my wife. This was really frustrating to me, since I felt that our lovemaking was too one-sided. I think it maybe bothered me more than my wife. In the past, I was very good at knowing her body and her response and I could bring about very nice orgasms by a combination of oral and manual massaging.
So, after reading your book, and doing some additional reading and research, I spent $225 on an Eroscillator. We had never experimented with sex toys, so I wanted to get something that looked like it would be effective, and this seemed to have the recommendations and documentation to back it up.
What a difference! The first time we tried it, we spent some time together getting warmed up, and I used the soft fingertip attachment on her. My wife had her first orgasm in six years within just a few minutes, and she cried in my arms afterwards. This has made a huge difference in our lovemaking, and my wife now has very strong orgasms.
We are still trying to figure out the best way to work it into our lovemaking, we had never used any vibrators or sex toys before. I love it because I now can be sure that I can please her, and I want her to be able to come first. I like it because it is nearly silent, and very effective.
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| “soft fingertip” |
Thank you, Tom, for your candor and for the details that will help other people in the same situation. As you know, I’ve been a fan of the Eroscillator (the soft fingertip attachment is my favorite, too!), and I found my own eyes starting to water when I read about your wife crying in your arms after her first orgasm in six years. As for how to work it into your lovemaking, the woman can hold it and use it for clitoral stimulation while her partner is caressing and arousing her manually, and she can also use it during intercourse, depending on the position.
“What would you tell others in your situation?” I asked Tom.
I would just tell others that there are ways to make things better. Talking with doctors and counselors can help, but I think that the familiarity of their doctors with sexual issues may be lacking, so specialists may be needed. I do know from personal experience how difficult it is to go to a doctor and ask for help on sexual matters. Requesting a prescription for Levitra was a very tough thing to do, so I can imagine that talking about more difficult issues can be very hard.
Fortunately, with some effort, the Internet can be a good source for information. That (Amazon.com) is where I learned about your book and blog, and I also picked up Dr. Ruth’s book. I also used it to search for different lubricants to try and learn about the Eroscillator. Especially for people who are not in a major city the Internet is a great tool.
73-yr-old man pleases wife with “ten fingers and a tongue”
A reader who wants to call himself “Buttonbob” sent me this email:
I am a 73 year old male. For the past few years I have been using Viagra. I must confess that most of the time it didn’t do the trick. But an old friend of mine reminded me that I had ten fingers and a tongue.
I found to my surprise that my lady didn’t need intercourse and was more than happy to settle for hugging and oral touching and caressing. Once over the shock I discovered I began to enjoy the touching and caressing even more, My advice to others is get over the idea that intercourse is the end all. Enjoy your close relationship with your spouse that touching and hugging can give.
This is a subject that comes up over and over. Many men think that intercourse is the goal of sex, and that if they have erectile difficulties, they might as well give it up. Not true! Sex is two minds, two bodies, and two hearts making love — not just two sets of genitals! There are many ways to please a partner without intercourse, and this reader is right on track with “ten fingers and a tongue”!
I welcome your comments.
Intimacy after prostate surgery
Several readers have posted and emailed me about sex and intimacy after prostate surgery. I asked Anne Katz , RN PhD, author of Breaking the Silence on Cancer and Sexuality: A Handbook for Health Care Providers and sexuality counselor at CancerCare Manitoba in Winnipeg, Manitoba, to respond to a common question:
Ever since my husband had his prostate removed because of prostate cancer, he has been reluctant to touch me. This is so upsetting. I love him very much and don’t know what to do.
It is common for men to be unable to have an erection after this surgery. Depending on the type of surgery (nerve sparing or not), his ability to have erections may or may not return. Many men are deeply distressed by this and may avoid all physical contact with their partner so as not to “lead them on” or disappoint them. This leads to a very unhappy partner who wants to express his/her love and support but feels cut off and cut out.
What is important is for the couple to TALK. It is often really difficult to talk about a sensitive topic when emotions are running high. But talking goes a long way to healing and connecting. Start with an “I” statement: “I miss touching you and being touched by you. How can we reconnect again?” Or perhaps: “I love you so much and want our relationship to be the way it was before the surgery. What can WE do to help this happen?”
While there are medications and treatments that may help, further treatment should be a couple’s decision and the man should always include his partner in medical appointments so that both people can express themselves and have their questions answered. Because communication is so important, the couple may need professional help to start the communication flowing. But seeking help is the first step.
For more posts about cancer and sexuality, please click “cancer” in the “labels” list in the right-hand column.
Is this helpful? Let me know what questions you’d like me to explore as we age and encounter physical and emotional challenges to our sexuality.
–Joan