Cancer and Sexuality

By: Dr. Denise Renye

In a recent blog on the clitoris, we mentioned how women’s sexuality is very understudied and neglected. For much of history, cis men were the ones in positions of power and the ones asking questions and leading research. That meant sexual health for people with vulvas was left by the wayside while sexual health for people with penises was not. We know a lot about erectile dysfunction, and insurance will cover Viagra, yet people with vulvas aren’t prepped on how cancer can devastate their sexual function.

A recent study found 66% of women with cancer experienced sexual dysfunction, like orgasm problems and pain. Researchers also found a high prevalence of issues like vaginal dryness, fatigue, and body image concerns. Patients expect to experience nausea but vaginal atrophy? Not so much. There’s anecdotal evidence to support how rarely people with vulvas are asked about their sexual health but there’s extensive research too.

A study from three years ago surveyed 391 cancer survivors and found 53% of male patients were asked about their sexual health by a healthcare provider, while only 22% of female patients said the same. Even more recently at last year’s annual meeting of the American Society for Radiation Oncology, 89% of men were asked about their sexual health at their initial consult for undergoing radiation for prostate cancer compared with 13% of women undergoing a consult for cervical cancer.

In other words, even in situations where sexual health should be talked about, it’s not. There’s a hunger for this, to talk about cancer’s effects on sexual health, that I’ve seen firsthand. When I lived in Philadelphia, I ran a support group for lesbian partners of women with cancer. It was very well-attended because there wasn't a lot of space for this type of grief to be expressed. And these spaces are needed. It is a severe disservice to women and the general public when there is not research and data collected on the basic needs and expression of the self.

There are issues that arise sexually that people feel like they’re not “supposed” to struggle with, either because they think they’re an anomaly, or because they think they should just be grateful that they or their partner survived cancer. Number one, research shows how common sexual dysfunction is, and number two, humans are complicated and more than one emotion may be present at the same time.

It is important to study women's sexual health because women have unique pleasure and health needs that differ from those of men. These issues are multifaceted and include sexual pleasure, menstrual understanding, sexual expression and communication, pregnancy-related curiosities and concerns, and menopausal transitions. Women's sexual health is not only essential for their physical well-being but also for their mental and emotional health because they are connected. Women’s sexual health issues are Women often face societal and cultural barriers that can impact their sexual health, such as stigma, lack of access to healthcare, and gender-based violence. Studying women's sexual health is crucial to developing effective and open education around communication of wants and needs, strategies of sexual expression, reducing health disparities, and promoting gender equity.

At Whole Person Integration we care tremendously about creating a safe space to discuss sexual pleasure and health as well as dysfunction. Instead of being a neglected part of people’s health, we want to bring it into the spotlight and give sexual health the attention it deserves.

Journal Prompts

·      Has my doctor or healthcare provider asked about my sexual health recently?

·      Is there anything I’m noticing that I could speak with a professional about?

·      Is there anyone in my life I feel comfortable talking about sexual health with? If so, who?

To set up an appointment with me (Marin County Sex Therapist), click here.

References

ASCO Post Staff. “Sexual Side Effects of Cancer Treatment Often Unaddressed With Female Patients.” ASCO Post. October 26, 2022. https://ascopost.com/news/october-2022/sexual-side-effects-of-cancer-treatment-often-unaddressed-with-female-patients/

Esmat Hosseini, Ph.D., Seyedeh; Ilkhani, Ph.D. Mahnaz; Rohani, Ph.D., Camelia; et al. “Prevalence of sexual dysfunction in women with cancer: A systematic review and meta-analysis.” International Journal of Reproductive BioMedicine. January 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8902793/

Florez (Duma), Dr. Narjust. “Sexual health in women with lung cancer.” World Conference on Lung Cancer 2022. Video published 8/9/22. https://www.youtube.com/watch?v=R93mCCLtZKU

Taylor, J; Ruggiero, M; Maity, A; et al. “Sexual Health Toxicity in Cancer Survivors: Is There a Gender Disparity in Physician Evaluation and Intervention?” International Journal of Radiation Oncology, Biology, Physics. November 1, 2020. https://www.redjournal.org/article/S0360-3016(20)32291-4/fulltext#%20