Ovacome Summer 2014

feature
The big taboo
Sex may be the last thing on your mind when recovering from an ovarian cancer
diagnosis. But there is plenty help available to get your mind and body in the
right place after treatment, says Dr Helen Fairhurst from the Winton Psychosexual
Medicine Clinic.
For many, returning to a normal sex life after treatment
for ovarian cancer can be difficult. But it is even more of a
problem if the subject remains taboo for patients, partners
and the medical profession. A study in the British Journal of
Cancer in 2003 * found that while a majority of healthcare
professionals thought most women
with ovarian cancer would experience
difficulties, only one in four doctors
and one in five nurses brought the
subject up with patients.
Things may have moved on since the
2003 study and some cancer centres
– such as Dorset, where I work
offer exceptional support to women
through their gynaecological nurses.
However, clinicians – and patients
themselves – often need to do more.
Dr Helen Fairhurst
For instance, there is a network of
pyschosexual clinics on hand throughout the UK, run by
members of The Institute of Psychosexual Medicine. Women
can access these clinics by self-referral or referral by their GP or
other health professionals.
And women themselves need to feel empowered to ask
questions. Your focus may be on getting over the cancer. But
don’t be afraid to bring up the subject of sexuality and how
it may be affected by the type of treatment you are having
as soon as you feel ready to discuss it. The sooner the better.
We know quality of life and general wellbeing can be greatly
enhanced if problems with sexuality are addressed early on.
Sexual problems are not always just down to physical reasons.
Emotional factors, not always experienced at a conscious
level, interfere with sexual pleasure. The underlying causes
of a problem may be physical or psychological in varying
proportions, but are rarely limited to one or the other.
There are several ways cancer and its treatments can undermine
a person’s sexuality. The impact of surgery, chemotherapy and
radiotherapy will be direct and physical. But there may be other
obstacles when it comes to intimacy, such as feeling disfigured,
too tired to bother, changes in sensory perception and difficulty
reaching orgasm. Also women can feel that their body, which
has been prodded and probed by the health professionals, is no
longer really part of them.
But remember, however, that the ‘core’ of your being inside
you is maintained, regardless of the treatment you have had.
Lack of libido
Low sexual desire or libido is a common problem. Many
different emotional and physical factors can affect sexual
desire and may be present in women living with cancer.
Tiredness, stress, relationship problems, menopause
symptoms, worries about children, elderly relatives, finances
and work, or difficulties accepting the changes in body image
that come after surgery are just some examples. And of
course, in some cases sex may be a low priority after facing a
cancer diagnosis and treatment.
Coping with illness symptoms and the effects of treatment
can be challenging enough. Women may feel too unwell to
summon up the energy for the exertions of sex, but still long
for physical closeness. Others find it difficult to enjoy sex
without thinking of their cancer.
At the same time, partners may have difficulty relating to
the anxieties and fears that come with a cancer diagnosis.
They might not understand why their partner feels less
sexy, especially once treatment is complete, and they
can see an outward return to normality. This can lead to
communication misfirings and a downward spiral becomes
established, just at the time when some love and support is
vital. If a woman is harbouring anger and resentment towards
her partner, it can be difficult to get in the right frame of
mind to enjoy sex.
Solutions will vary from person to person, but discussion with
partners, friends and health professionals is often beneficial.
Patients often ask about using hormones to improve their
libido. While it is true that both oestrogen and testosterone
are needed for good sexual function, and are reduced by the
removal of both ovaries, many other factors can influence
sexual desire. This means that hormone replacement may
not be the solution. Also, there is uncertainty about whether
taking these hormones to deal with a sudden surgical
menopause could increase cancer recurrence risk.
A recent study showed that women given Hormone
Replacement Therapy (HRT) after a surgically induced
menopause following treatment for epithelial ovarian
cancer ** had improved longevity as well as a good control of
10 Phone Ovacome’s nurse led support line on 0845 371 0554
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