Sexual health affects every part of our lives (physically, emotionally, and mentally), especially after extreme body changes such as cancer. Surviving cancer is one thing, but living with the side effects is a whole other type of monster. It is difficult for most of us to open up about sexual dysfunction, and especially after cancer there may be a lot of issues that are confusing and are hard to work through.

Asking for Help

In a recent study, 45% of any cancer patients will initiate a conversation with their doctors about sexual health after treatment. Of those, 45% found the conversation to be successful. It is also more likely that men will bring it up than women.1 However, another alarming statistic shows that 71% received no treatment at all for sexual health due to fear of bringing the topic up at all.

Pelvic Floor Physical Therapists

Pelvic floor physical therapists have unique experiences that really help this population through knowledge of the pelvis and sexual health physically. Education is power so here are some things you should know about how sexual health is compromised after cancer treatment:

Vaginal dryness

Scar tissue

Burns

Decreased range of motion from scarring

Painful Sex

Decreased desire

Reduced self esteem

Infertility/ Hormone changes

Lymphedema/ swelling

Other side effects of treatment: nausea, vomiting, fatigue

Side Effects of Cancer Treatment

Often times it is not the cancer itself that affects sexual health, but it is actually the side effects of the treatment.

Radiation can specifically be damaging especially if it is done to the pelvic region. It can cause vaginal dryness or scarring. When scar is laid down it tightens the skin and thus causes decreased range of motion and decreased sensation- making sex painful and also making positions difficult to get into. Patients may also suffer from burns that are painful to the touch, which can make intimacy more difficult.

Chemotherapy can exacerbate a lot of these issues including worsening scar tissue and creating more dryness. Chemotherapy also causes other side effects including nausea, vomiting, and fatigue that make initiating any sexual contact undesirable. In some instances, chemotherapy or hysterectomies (which get rid of some cancers) can put you into menopause if you are of a younger age. This not only will make hormonal changes (causing worsening vaginal dryness and labial atrophy), but it also can potentially cause infertility.

Lymphedema is a result of all these treatments that can cause swelling in any area of the cancer especially if they had to remove lymph nodes for staging. The swelling causes mobility issues and overall low self-esteem.

All of this can ultimately decrease sexual desire in general.

Treatment

All of that sounds frightening, but that’s why pelvic floor physical therapists exist! Cancer treatment can impact sexual health on multiple levels making treatment also multi-factorial. Women’s health physical therapists are trained in lymphedema treatment and pelvic floor giving us a unique perspective on your sexual health journey after cancer. We are knowledgeable about the anatomy, the physiology, and the hormones that may be affected. We manually help with scarring and painful sex, give you tips on vaginal dryness, and perform lymphatic drainage techniques to reduce swelling. We improve range of motion and also educate you on positions during sex in order to decrease pain and optimize pleasure. Lastly, we work along side your providers including sex therapists in order to partner with the emotional side of sexual health while simultaneously taking care of the physical part.