Your sex life and what can change it

Cancer and its treatments might affect your sex life. It can help to know what is normal for you so that you can understand any changes that happen.

What is a normal healthy sex life?

There's no such thing as a normal sex life. Different people have very different sexualities and sex lives. Normal is just what’s right for you, on your own or in a relationship with someone else.

If you do not feel comfortable discussing your personal sexual preferences or how often you enjoy sex, this might make you wonder if your own sex life is normal.

Your sex life may include:

• whatever gives you and your partner enjoyment
• having sex daily, weekly, monthly, or less
• cuddling, kissing or holding hands without needing to continue to sexual intercourse
• touching and pleasing yourself sexually (masturbation)
• using sexual aids such as a vibrator
• losing interest in sex at certain times in your life – this may be caused by stresses such as illness, financial worries or a broken relationship

The list could be endless. It really is up to the individual person. Some people want to have sex more often than others.

Some men may feel they should be able to have an erection whenever their partner feels like sex. Some women feel inadequate if they don’t orgasm every time that they have sex. But none of this really matters as long as you feel happy with your sexuality and sex life.

If you are in a relationship and you and your partner feel comfortable with your sex life, then reassure yourself that things must be normal for you both. Just feeling close to someone and knowing that they are there for you, may be just as important as having great sex.

Likewise, it doesn’t necessarily take being in a sexual relationship to be normal. It is perfectly normal for single people to enjoy sexual pleasure without a partner. As we mentioned before, your sex life is how you feel about yourself and your sexuality, and whatever fulfils you sexually.

Your body during sexual activity

Men and women go through physical mental and emotional changes during sexual activity. Doctors and psychologists sometimes talk about the 5 phases of sexual activity, or the sexual response cycle.

The emotional and mental changes are very individual, and we all react to sexual stimulation in our own way. The basic physical changes that happen are generally the same for all of us.

Phase 1

The first phase is the feeling that you want to have sex, known as libido or sexual desire. This can last a few minutes or several hours. You may want to have sex every day or much less often than that.

Phase 2

The second phase is arousal or excitement, meaning that your body begins to respond to your desire to have sex.

For women this can mean that their vagina lubricates, their nipples become erect, and their breasts and clitoris fill with blood, making them swell.

For men, their penis fills with blood and becomes erect. Because of the increase in blood in the body, both men and women have faster heart rates and breathing, and their genital area becomes redder or more purple in colour.

Phase 3

This arousal can last for a while and is known as the plateau phase.

Phase 4

The fourth phase is orgasm or climax, which means the height of sexual pleasure. This is the shortest stage of sexual activity. During this phase you may have a feeling of warmth spread throughout your body. During an orgasm certain muscles throughout the body contract involuntarily, including muscles in the anus and pelvic area. Not everyone reaches this phase every time they have sex. But if you do it can be a very intense and enjoyable experience.

Phase 5

The final phase is called the resolution phase. During this phase your body returns to its normal state. A man’s penis softens and goes back to its normal size and colour. Women’s breasts, nipples, clitoris and vagina return to their normal state and colour. Your heart rate and breathing go back to their previous rates.

During the resolution phase, a man can't have another orgasm. How long this lasts for usually depends on your age. For most younger men, it only lasts a few minutes. But if you’re ill or elderly it can take a few hours or sometimes days. This is called the refractory phase. Women don’t have this phase and can potentially have orgasms one after another (multiple orgasms).

Things that may change sexual responses

Many things can change how your body reacts during any of the 5 phases of sexual activity. They can include:

• tiredness (fatigue)
• feeling sick
• pain
• bowel problems due to cancer treatment
• surgery or radiotherapy to your pelvic or genital area
• your state of mind – depression, stress, fear, anger and anxiety
• side effects from certain drugs such as chemotherapy, blood pressure drugs, alcohol, nicotine, painkillers, and anti sickness drugs
• feeling unhappy with changes to your body caused by cancer or its treatment
• hormone imbalances in the body
• problems with the nerves or blood vessels in your pelvic area
• personal problems such as financial worries, work and relationship difficulties

Many of these problems can happen when you have cancer, which can mean that you’re less likely to enjoy or want to have sex. This can be hard to cope with.

Talking about sex and your sexuality

Some people find it hard to talk about their sexuality and sex life. 

Cancer and treatment may mean that you can't have sex or do not feel like it. These issues might feel very private. But if you have any worries it might help to talk to a close friend or your partner about them.

If you are in a relationship

If you are in a relationship and try to keep your concerns to yourself, your behaviour may confuse your partner. They may feel rejected or think that you no longer love them or feel attracted to them.

If you and your partner stop having sex it often affects other types of intimacy. You might avoid hugging and kissing because you worry that it could arouse your partner and then upset them because you don’t want to go on and have sex.

Sometimes people with cancer avoid physical contact with their partner because they are unhappy with changes to their body.

Some types of cancer or treatment might affect a man's ability to have or keep an erection. Men might worry that they cannot pleasure their partners anymore. It is important to allow time to come to terms with changes to the body.

It might not seem like it now, but in time most people are able to enjoy a physical and loving relationship with a partner. It might be a bit different from what you were used to.

How talking can help

If you're able to talk to your partner about your worries, you will both gradually get used to your new situation and things will feel less awkward. A caring and loving partner can help to ease your concerns. You might also find it helpful to talk to your doctor or nurse about how you are feeling. They might suggest that you and your partner have some counselling to support you through this difficult time.

If you are single

Changes in your appearance (such as scarring), or physical ability to have sex (such as erection problems) might make you feel less confident about sex. You might avoid getting into a relationship as a result.  

It might help to talk to a close friend or counsellor about how you are feeling.