Women's wellness: Sexual health after cancer treatment
Following a cancer diagnosis, patients often ask many questions about their treatment and possible side effects. One area that is often overlooked is sexual health, which experts say is important to talk about to ensure quality of life.
Dr. Jacqueline Thielen, a Mayo Clinic general internal medicine physician, says it's normal for patients to experience changes during and after cancer treatment, and she encourages men and women to talk with their provider about concerns.
"Sexual dysfunction comes in all shapes and sizes, and it's normal to experience changes after cancer treatment," says Dr. Thielen. While there are several areas of sexual health, the most common sexual dysfunction is low desire. "Or what we call hypoactive desire disorder, the lack of interest in sex," says Dr. Thielen. Both male and female patients also may experience difficulty with arousal and the ability to be orgasmic, says Dr. Thielen. For women, though, pain is often the first sign of an issue.
"Dyspareunia is the medical term for the pain that a lot of women will experience after cancer treatment, especially if their hormones have been affected. The loss of estrogen, specifically, often will result in changes in the vaginal mucosa," Dr. Thielen explains. "The cells are not able to lubricate like they should, and we lose elasticity of those vaginal walls, too. So subsequently, there can be pain."
Dr. Thielen says that a discussion with your health care provider is important because not every patient will experience the same dysfunction in the same way. "Sexual health is an integral part of the human condition, and it's important to recognize that it's varied."
Sexual function issues also may be unrelated to cancer care, so Dr. Thielen encourages patients to speak to their health care provider about concerns before, during and after cancer treatment. "It's important to recognize, especially when it comes to sexual functioning, that changes can be caused by various diseases throughout the body system organs. So do not be afraid to ask your provider, be it a primary care provider or a specialist," she says. While some issues may be straightforward, each patient deserves a personalized approach.
"We can point them in the appropriate direction in terms of a treatment plan. Some patients may require a visit with a sexual therapist. Some may not. For other patients, it may require working with a physical therapist on pelvic floor dysfunction. Or, it might be as simple as having a conversation about what to expect in terms of what's normal in sexual functioning," she says.
©2020 Mayo Foundation for Medical Education and Research
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