5 Questions on Sex Health and Cancer

By Sarah Garcia - January 08, 2021

Are you embarrassed to ask your doctor about the potential impact of cancer and cancer treatment on your sexual health? Don’t be. “These problems are not unusual. Sexual health is just as important for people with cancer,” says Dr. Kristine Donovan, a clinical psychologist in the Department of Supportive Care Medicine at Moffitt Cancer Center. From how to broach the subject with your provider, to how to work on restoring sexual function and having a healthy sex life post-cancer, we asked our experts to answer some important questions on sex health and cancer.

Why is it important for cancer patients to discuss sexual health early on?
Sexual health is an important part of our overall health, according to Dr. Smitha Pabbathi, medical director of the Survivorship Clinic at Moffitt. “When providers become comfortable with preparing patients on what to expect, it can have the potential to decrease treatment related anxiety, worry and poor quality of life.”

How can I have “the talk” with my doctor and what questions should I ask?
Sexual side effects can have a profound effect on a patient’s quality of life and the quality of their relationship. “There are therapies available to address these effects, so it’s important to discuss your concerns with your provider,” said Donovan. Although this is a sensitive subject for many patients, she emphasizes that these issues are not uncommon and it’s important to address them with your doctor.

Donovan recommends starting with these two questions: How will this affect my sexual health? And what changes in my sexual functioning and ability to be sexual should I expect?

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"When providers become comfortable with preparing patients on what to expect, it can have the potential to decrease treatment related anxiety, worry and poor quality of life."

- Dr. Smitha Pabbathi, medical director of the Survivorship Clinic at Moffitt

What resources does Moffitt offer to help patients with sexual health issues?
“Many of Moffitt’s providers, including nurses and advanced practice professionals, are well informed about sexual side effects of cancer and cancer treatments, and can provide information about potential problems and their causes as well as specific suggestions for overcoming problems,” said Donovan. “They can also make referrals for medical testing and treatment.”

In addition, Moffitt’s Survivorship Clinic is a resource for many patients when it comes to recommending therapies to address sexual side effects. “Our clinic addresses sexual health and body image with all new patients when they complete a comprehensive clinical needs assessment tool,” said Pabbathi. “We discuss best opportunities for treatment in the clinic as well as leveraging wonderful resources like Dr. Donovan in behavioral medicine and others in the community.” Donovan provides brief sexual counseling to help patients manage changes in their sexual health and address the effect of these changes on their sex life.

What are some common sexual side effects of cancer or cancer treatment?
Some of the most common side effects for women include loss of desire for sexual activity, vaginal dryness, pain with penetration, vaginal shortening and narrowing. For men, common side effects are erectile dysfunction, loss of desire for sexual activity, alterations in orgasm or difficulty reaching orgasm.

According to Pabbathi, sexual health concerns can also be a challenge in cancer survivors even many years after successful completion of cancer therapy. “In a retrospective study we conducted looking at cancer survivors’ unmet needs, the most common identified unmet need was erectile dysfunction for men and vaginal dryness for women,” she said. 

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"Exploring new and different ways to be sexual may lead to a greater sense of emotional and physical intimacy, at a time when what may be needed most is a life-affirming connection with another."

- Dr. Kristine Donovan, clinical psychologist

How can I regain sexual health and function after cancer?
Even when sexual side effects of cancer are permanent, Donovan says you can still find satisfaction in your sex life. 

“Oftentimes, what helps is a willingness to redefine sexual wellness and to focus on what one can do alone or with a partner,” she said. “Exploring new and different ways to be sexual may lead to a greater sense of emotional and physical intimacy, at a time when what may be needed most is a life-affirming connection with another.”

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