The majority of adults believe that sexual health (i.e. intimacy of any kind) plays an important role in quality of life. Ultimately, sexuality and intimacy is defined by each person according to sex, age, personal attitudes, and religious and cultural values. Many people that live with a chronic illness or have survived cancer feel that this part of their life is over. But it doesn’t have to be!
There are many things that can be done for sexual dysfunction and we base treatments on the cause. Causes of sexual dysfunction include the following:
• Physical: nerve problems, cardiovascular disease, cancer (disease, surgery or treatments), breathing problems, fatigue, sexual pain, vaginal dryness and menopause.
• Medications: Some medications can result in decreases in libido while others cause vaginal dryness or sexual pain problems. Alcohol and drugs may also cause problems.
• Psychological: Depression, anxiety, prior abuse, stress, and issues surrounding body image.
• Relationship: Partner health, conflict or lack of privacy.
• Socio-cultural: conflict with religious, personal or family values.
So what can we do to help you? Lots. Exercise can be very helpful. It can increase desire and improve body image. Good communication with your partner is also important. What leads to orgasm or pleasure before may not necessarily be what you need now. Discuss your fears and needs with your partner openly. If you need help in this area, there are wonderful sex therapists you can be referred to. Plan sexual activity when your energy is the highest and when you feel the best. Plan date nights. Focus on pleasure rather than performance. There are many vaginal moisturizers out there for vaginal dryness that have no hormones, perfumes or glycerin in them. The best one I’ve found is Liquid Silk which is available on drugstore.com. Explore medication changes with your primary care team as these might also be part of the problem. Occasionally hormone therapy is used but only if your team feels this is safe. Certainly with hormone dependent cancers, we want to avoid these. If you have vaginal or sexual pain there are lots of aids as well such as dilators and such but commonly pelvic floor physical therapy is needed to show you how these can help. If positioning is difficult there are special pillows and wedges as well as chairs to by. There are also a ton of books out there to help as well such as Reclaiming Desire by Andrew Goldstein if libido is your issue. Becoming Orgasmic by Julie Heiman and Reclaiming your Sexual Self by Kathryn Hall are also very good.
Remember: communicate well with your partner, do something different and have fun!
For more help on any of the above please contact Jessica Johnston, MD NCMP at (920) 996-1000.
Dr. Jessie Johnston
Family Practice