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Finding A Good Feeling

Vol. 5 - Physical Responses

The way we see ourselves and the way we believe our partner sees us affects our sexuality. The past two blog posts provided some insight into how to address self-image issues. Yet, there are some physical responses our body goes through that affect sexual pleasure.

During cancer treatment, the desire for sexual activity can decrease. Naturally, the first focus is on surviving. But sex pleasure is an important part of one's health. Cancer treatments create a number of physical ailments making sexual pleasure more challenging. Over time the desire for sex may increase, but side effects and hormone therapies may alter or deter sexual desire.

Let's be honest, medically induced menopause is abrupt and intense... the slow changes that normally would happen do not occur... you are just instantly thrown in menopause. Plus, many women have to take estrogen blocking cancer drugs triggering menopause or menopausal symptoms. Like dealing with cancer isn't enough, let's just make you endure a bunch of aging symptoms. Women taking these hormone inhibitors are likely to develop sexual problems.
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Some treatments damage nerves and muscles that normally would respond to pleasurable touch, like surgeries and radiation. Now the things that once felt good, might actually be painful. The breast, or area where your breasts were, may now have nerve pain or discomfort. Sometimes penetration hurts due to tightening or dryness. The stress and pressure may induce vaginismus (where the muscles around the vagina tighten making penetration difficult). And even though things have changed, there are some ways to help improve these things and make sex more satisfying.

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Addressing Painful Sex

There are some ways to help improve sexual pleasure. However, you need to know yourself and understand why or what is happening to your body. Whether that is nerve problems from surgery or radiation damage or lymphedema or vaginal dryness... these are just part of the new you. And the new you deserves a rewarding sexual life.

General Approaches

  1. Know when you hurt and when you don't. Try to have sex when you feel your best... would sex be better in the morning? noon? or night? Do not wait until your worst time to initiate sex. If you take pain medications, then wait for 45 min - 1 hr afterwards, so you know your medications are working.
  2. Invest in lube! Vaginal dryness and tightness can make penetration uncomfortable. Lubricants are an important sexual aid. I am all about coconut oil for a lubricant. It's natural and works for me. However, find what works for you and use it. Some people will use prescribed vaginal creams. They add moisture back to the vaginal canal and elasticity, but may be off-limits for some ERPR cancers
  3. Be creative. The sexual positions you used to use may not work anymore. Find positions that place less pressure on your sore areas. Use pillows. Change positions. As your partner to take over or handle more of the physical movements in sex. Again, be creative!
  4. Use your mind. Try to focus on feeling pleasure. Often pain can be lessened when you are aroused. Make sure to remind yourself and allow yourself to feel the pleasure.

Genital Pain Approaches

Sometimes cancer treatments can create genital pain. Some treatments actually damage the tissues. Some medications impede the natural lubrication. There are ways to try address these issues.

  1. Ask your doctor. There may be some solutions. Do not be embarrassed... sexual health is part of total health.
  2. Get aroused before you start. Before you actually have penetration, focus on foreplay. The vagina needs excitement to expand and produce lubricant, so take the time to get fully aroused first. In case you missed that, make sure you have the time to get aroused before you actually have sex.
  3. Be vocal. If something hurts tell your partner. Be willing to try new things and stop if needed. As we already addressed, communication leads to a healthy sex life. (Read here if you haven't seen that blog post!)
  4. Take charge. If you have vaginal pain, then you may want to make sure you control the movement during sex. Basically, you may want to control the speed and thrust depth. The control over the sex may help.
    • A good position for this is to be on top of your partner (kneeling).
    • A good position for this is lying on your sides (spooning) either face-to-face or behind you.
  5. Loosen up with your partner. You may need to have your partner actually stretch your vaginal area with his fingers prior to penetration. A gentle massage that works to relax the vagina (starting with one finger and lots of lubricant).
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Kegels are exercises for the pelvic floor and vaginal muscles. They are important in treating vaginal pain and overall great for sexual health. Kegels allow for you to tighten and relax vaginal muscles during sex. For women experiencing painful penetration due to tightening, this allows for control to relax the muscles aiding in less pain during penetration.

How to Kegel?

People often do not know how to tighten the vaginal muscle. The best advice I have is when you are using the bathroom to urinate, stop the flow of pee. Do not do this regularly, but try it one or two times to learn the sensation and how to contract the vaginal muscles.

Now that you know what it feels like, do the same tightening regularly to gain control over the muscle. Just like any exercise you need to build the muscles. Try to hold the contracted muscles for 3 to 6 seconds for 5 to 10 times. Work your way to holding it 6 to 10 seconds for 20 to 25 times. You can Kegel anywhere and no one will even know you are doing it.

Vaginal dilator

These are actual cylinder shaped devices to help stretch the vagina. They are used to help the vagina from shrinking or for tightening due to treatment. These are not dildos or vibrators, and it's purpose is not sexual pleasure, but medical. There are different types depending on what you may need. Talk to your doctor if you are interested or believe you may need one.

Final thoughts

Feeling good about yourself, focusing on the pleasure, communicating with your partner, and finding ways to increase physical stimulation are all important in creating a positive sexual experience. Cancer treatment can change the physical stimulation and pleasure, but keeping your sex life is important too.
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It may take a lot of practice and patience, but do not give up on working towards a positive sex life.

Remember if sex hurts, you can stop. You can try again later or try something different. If you are still struggling, find a sex therapist, talk to your gynecologist.


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