Dating, Sexual Health, and Intimacy

Navigating dating, sex, and relationships can be challenging at any time, and can become even more fraught if you’ve received a cancer diagnosis or during and after treatment. Remember that you are not alone. Do not hesitate to seek support, whether that’s from your doctor, healthcare team, or other trained professionals.

Emotional Challenges 

A cancer diagnosis can bring up not only anxiety, insomnia, PTSD, or depression, but also concerns about fertility, your evolving body image, and how to communicate your condition to a partner. Deciding when and how to share this information is personal. You may feel that your diagnosis is private or important to disclose early in a relationship. It is up to you to decide how and when you share this information.

Specially trained social workers and therapists can help you navigate these conversations. Many oncology clinics employ professionals who specialize in sexual health concerns; talk to your doctor to see if they can recommend someone.  

If you are a young adult grappling with a gynecologic cancer diagnosis, read more about the emotional challenges you might encounter here.

Physical Side Effects 

The physical side effects of treatment can compound emotional challenges. Recovery from surgery can take several weeks, resulting in possible fatigue and changes in libido. Early onset menopause can affect sexual pleasure and desire. Loss of estrogen may lead to vaginal dryness, discomfort, or even pain during sex. Estrogen depletion and scarring from radiation can also cause a shortening of the vagina.  

Sexual changes after cancer treatment can be scary. You may wonder if they are permanent, or if you will ever be able to enjoy a satisfying sex life again. Fortunately, some of these are short-term changes, and there are effective solutions for many of them.

Solutions and Tips

For vaginal dryness: Over-the-counter moisturizers daily, and lubricants during intimacy, can help manage this symptom.
For vaginal shortening: Regular vaginal penetration and intercourse or using vaginal dilators can help to stretch the vaginal walls.
For sexual dysfunction: Talk to your doctor about approved medications designed to help combat female sexual dysfunction. Pelvic floor physical therapists and sex therapists are specially trained to help you regain physical well-being and a sense of yourself.
For intimacy issues: You and your partner may both have worries and concerns around the changes you may need to ensure sex is comfortable, safe and pleasurable. Remember that there are many ways to give and receive pleasure. Open communication with your partner can help reestablish a sense of intimacy when you’re ready.   Watch a video on Sexuality and Intimacy After Cancer.

Fertility and Surgical Menopause

The emotional and psychological repercussions of experiencing surgical menopause or compromised fertility as a result of gynecological cancer treatment can feel overwhelming, especially if you planned to have biological children or wanted to expand your current family.

Remember that many others who have gone through this journey are here to support you. Read on for information about fertility preservation, options to have children by means of alternative methods, and tips on how to cope with the physical and emotional changes of entering surgical menopause. You can also read stories of young survivors coping with dating after gynecological cancer treatment.

Fertility Preservation

Discuss fertility preservation with your doctor before starting treatment, even if having children isn’t in your immediate plans, as treatment for ovarian cancer can reduce fertility. Bring a partner or friend to help you understand your options.

Impact of Treatment on Fertility

Facing the possibility of infertility due to treatment can bring up a wide range of emotions, from fear and grief to anger and regret. It’s normal to feel this way.

Remember that you have options and there are many ways to become a parent. Read on for a description of how treatments can impact your fertility and actions you can take to preserve it.

Chemotherapy:

Certain drugs can cause acute ovarian failure, reducing fertility.
Chemo can damage healthy cells in the reproductive system, leading to infertility or premature menopause.

Surgery:

A salpingo-oophorectomy (removal of an ovary and fallopian tube) may be necessary, significantly impacting fertility.
Depending on the stage, a unilateral or bilateral salpingo-oophorectomy may be performed.

Options for Fertility Preservation

: Eggs are harvested, fertilized, and frozen. This requires hormone injections to produce eggs and a partner to provide sperm. Costs can be high, around $12,500 per cycle plus storage fees.
: Similar to embryo cryopreservation, but only eggs are frozen. This option is suitable if you don’t have a male partner or donor. Costs are approximately $12,000 plus storage fees.
: Shields block radiation from the pelvic area to protect the ovaries during treatment.
: Surgery to reposition ovaries out of the radiation path.

Cancer and Pregnancy

While rare, a diagnosis of ovarian cancer during pregnancy requires specialized care. Discuss treatment options with both a gynecologic oncologist and an OB-GYN. Involve a social worker or therapist to navigate your needs and options.

Surgical Menopause

A complete hysterectomy, including removal of the uterus, ovaries, and fallopian tubes, may be part of the treatment. This leads to surgical menopause, causing significant hormonal changes and side effects.

Menopause Side Effects and Coping Strategies

While surgical menopause can lead to an array of side effects, there are many different ways to manage them.

Hot Flashes: Manage with exercise, acupuncture, and layered clothing.
Sleeplessness: Consider medications or melatonin supplements. Speak to your doctor for recommendations.
Mood Swings: Yoga, exercise, and personal support can help.
Concentration Issues: Minimize distractions and keep notes or make video reminders.

You may also experience vaginal dryness or other sexual side effects as described above.

Remember that your doctor and care team are there to help you with managing side effects of surgical menopause. They can also recommend therapists or support programs where you can meet with and learn from other patients and survivors who have gone through a similar journey. For more information on menopause, sexual health, and fertility, see the resources listed here.

Options for Building a Family After Treatment

Fortunately, there are many options for building a family after treatment for gynecologic cancer, from using donor eggs or embryos to surrogacy and adoption. Read more about potential avenues and resources that can be helpful if you choose these routes.