Sharon Bober, PhD, Psychologist, Dana-Farber Cancer Institute, and Assistant Professor in the department of Psychiatry at Harvard Medical School, chats with us on this episode of the DiepCJourney podcast. I met Sharon through the Scientific Network on Female Sexual Health and Cancer where she is the current chair of this organization. Our topic in this blog summary of the podcast; sexual health program for cancer patients.
Why Sexual Health is not Often Talked About
I feel the intimate and sometimes uncomfortable nature of the topic, sexual health, is one of the major reasons it is not often talked about at consult for cancer patients. Dr. Bober points out very few medical professionals have formal training in sexual health. Further, she points out managing sexual disfunction remains outside the bounds of normal conversation.
A noticeably clear statement she makes is, “We live in a culture that is suffused with images of graphic sexuality.” These images do not represent real sexuality. She calls this the elephant in the room. These pictures are not often what many women can relate to especially when their bodies are assaulted with cancer treatment, surgery, and ongoing medication.
This list represents some of the possible specialists breast cancer patients may have on their healthcare team.
Many are not well-versed in the topic of sexual health. This is understandable since each medical specialty focuses on their specific area of expertise. However, the conversation can be brought up and they can, at the very minimum, make a referral.
Defining Desire: Sexual Health Program for Cancer Patients
Dr. Bober says it is important to define desire and how it changes over time. It certainly does not look the same for a couple on a honeymoon vs. someone who has been married twenty-five years. Watching a romantic TV or movie where all the stars are aligned is certainly not day to day reality. She points out too often our expectations of desire are shaped by cultural constructs that are very artificial, with or without a cancer diagnosis. So, imagine the pressure this can put on a cancer patient as they go from diagnosis through treatment.
When desire changes or decreases due to treatment, age, or hormonal changes, compared to what we knew when we were younger, some translate these changes as “I no longer have desire.” She points out sexuality and desire is at the intersection between mind, body and relationship dynamics making it far more complex than most realize. Dr. Bober points out it is more beneficial to look at desire as something to cultivate and anticipate rather than something that is just automatic. This can mean less pressure for the individual allowing them to be open to finding new ways to explore what actually nourishes their desire.
Putting Together an Action Plan in the Sexual Health Program for Cancer Pateints
A risk factor in any sexual partnership is non-communication. Finding the right place and time to have open communication about individual needs for intimacy and sex is important. Most of us are rarely brought up being taught this skill leaving many couples to learn the technique of sexual health as they go or when the need arises. Honoring one’s own body and staying as healthy as possible, even during treatment can bring a sense of confidence that reflects a trust in your body again after cancer. Consider this action plan.
- Find a professional who can guide you through sexual communication.
- Ask your partner, “Can we talk about this?” as a conversation starter and plan a mutual time to discuss it.
- Honor and maintain trust in your body by practicing good health and exercising in as much as you can during treatment. This has the potential to positively affect your self-esteem.
- Exercise can authenticate your personal vitality, flexibility, and strength.
Speaking to Your Healthcare Team About Sexual Health Products
Any treatment can disrupt sexual function, especially in the genital area. Women are affected by vaginal dryness. Keeping genital tissue healthy is important to sexual function. Ask your healthcare professional what is safe to use to help with this.
Vaginal moisturizers and lubricants should be considered when vaginal dryness occurs. These moisturizers should be a regular practice, a bit like moisturizing our face every day! It can reduce pelvic friction thereby reducing pelvic pain. Please ask your healthcare provider for the most pure, safe product to use after breast cancer. Ask those who are informed, particularly your oncologist. Dr. Bober states, “Find a moisturizer that works for you.”
Sexual Health and Exploring Your Needs
Women have various stimulation needs. Self-stimulation, masturbation, can bring self-awareness in knowing what feels natural to you. Vibrators are products that can help with exploring stimulation needs. You can introduce this with your partner as part of the repertoire of methods to explore together. Sexual aids are both pleasure oriented and important to explore what feels comfortable in your body after cancer.
Dr. Bober goes on to discuss the importance of exercise for the pelvic floor, vaginal dilators, and the importance of flexibility. It is a fascinating and important discussion. Let’s put the discussion about sexual health for cancer on the map by starting with this podcast. Be sure to check out the resources at The Women’s Scientific Network on Female Sexual Health and Cancer for more resources. You can listen to the entirety of the podcast here.