As Valentine’s Day approaches, we are focusing on sexuality in cancer survivors and previvors. Did you know that there are specialists in this area who can help you (and your partner) to get back in the groove if your libido is low? Here are some tips on regaining your libido from Sharon Bober, PhD, Director of the Sexual Health Program at Dana Farber Cancer Institute in Boston, MA.

Loss of libido or low desire is one of the most common and frustrating problems that cancer previvors and survivors face, especially after undergoing treatment that results in either early menopause or intensified menopausal symptoms.

Loss of hormones, estrogen in particular, leads to a significant loss of natural lubrication and elasticity of the genital tissues. We know that when a woman experiences vaginal dryness and vulvar discomfort such as itching or chafing, sexual activity can become uncomfortable or painful. Without a doubt, pain is a primary reason why women quickly lose interest in sexual activity.

However, when it comes to low desire, there are often additional ingredients in the recipe.  Previvors and survivors may find themselves feelings somewhat distanced or detached from their bodies after undergoing what may be a series of difficult treatments that not only significantly alter physical appearance but also result in loss of sensation and the experience of body integrity.  Even though a woman may hear people say “you look good” after treatment or surgery or breast reconstruction, some of these changes may not be obvious or easy to talk about and they certainly can affect how a women perceives her body image and sense of sexuality.

Furthermore, it is not uncommon for women and their partners to stop having sexual activity for weeks or months during the acute phase of treatment and it can then be anxiety provoking to think about re-connecting with a partner on the other side. Women may worry whether partners still find them attractive and communication about how to approach sexual activity is not easy for many couples, even without cancer in the picture. Certainly “negative self-talk” such as “I feel damaged” or “I think things will never get better” also contributes to wanting to avoid intimacy.  In addition, other common cancer-related experiences such as fatigue, weight changes, and anxiety also decrease desire. Many medications such as pain meds, anti-depressants and anti-nausea drugs can lower libido as well.

So what does this mean? The most important place to start when it comes to reconnecting with desire is the idea of starting a new chapter in your sexual journey. First, this means inviting yourself to get to know your new body with a sense of kindness and curiosity. Second, choose to focus on what is pleasurable, rather than on achieving some goal. When trying to have sex becomes like planning for a military campaign, it’s never a good thing. It is so important to take the pressure off and start out gradually by noticing sensation and introducing sensual pleasure into daily life such as non-sexual touch. Further, many women find it easier to “practice” on their own, before getting started with a partner. For example, getting a good lubricant and trying out a vibrator to get some pleasurable clitoral stimulation not only allows for healthy blood flow to the genital tissue, but it might allow you to figure out what kinds of sensation feels preferable. Many women find it easier to communicate what feels good after they have had a chance to explore their own body first. 

Most importantly, research has shown us that desire becomes an experience that is not spontaneous for most women by mid-life, but rather is an experience that has to be cultivated. This means that women need to have thoughts or experience that feel pleasurable or arousing which in turn, jumpstart the feeling of being “in the mood.”

This might mean expanding the repertoire, using fantasy, relaxation exercises or extending foreplay. In other words, most women need to have some kind of pleasing, romantic or sensual experience in order to get in the mood and that is perfectly normal!

It is absolutely true that women can get their groove back! Making time for intimacy, introducing more sensual pleasure into daily life, inviting your partner to use this new chapter to join you in “dating” again and expanding one’s repertoire such as using fantasy and extending foreplay are all powerful strategies for sexual renewal and increasing desire. The good news is that there is no one right way to get started and any step that brings you some sensual pleasure and romance is a perfect way to put a toe in the water…

Happy Valentine’s Day!