How to talk to your doctor about sex and cancer | Norton Healthcare Louisville, Ky.

How to talk to your doctor about sex and cancer

Sexual health is important for every adult — Here are tips for starting the conversation

Sexual health is important for any adult’s well-being, but patients with cancer face a new set of challenges when it comes to sexuality. Laila S. Agrawal, M.D., breast cancer oncologist with Norton Cancer Institute, is spearheading efforts to develop a sexual health clinic at Norton Healthcare.

“The World Health Organization says that sexual health is fundamental to the overall health and well-being of individuals, couples and families, and that this is relevant throughout the individual’s lifespan, not only in reproductive years,” she said.

Cancer’s effects on sexual health

“When we are thinking about sexual health and sexual dysfunction, we look at the big picture,” Dr. Agrawal said. “So many domains affect the body’s sexual function. From hormonal changes, loss of sensation and mastectomies, to changes in body image and low libido, cancer patients face myriad symptoms and experiences.”

Sexual health is the third most common concern for cancer survivors, and issues are associated with poor quality of life and mood disorders. Yet, many doctors are reluctant to bring up the subject, or the cancer diagnosis takes precedence over every other aspect of the patient’s life.

“Sexual health issues caused by cancer and treatments do not magically disappear on their own,” Dr. Agrawal said. “The more I talked to my patients about this, the more I learned. This is a medical issue we need to address.”

How to talk to your doctor

Ask about sexual health and acknowledge its importance.

Despite being such a prevalent and important issue, it often is not discussed with physicians.

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In a 2020 survey of over 400 cancer patients (most of them female), 87% of patients said cancer treatment impacted sexual function and/or desire, including pain with sex, body image distortion and the inability to achieve orgasm. Only 28% had been asked by a medical provider about sexual health, and female patients were less likely to be asked than male patients.

It’s normal to feel anxious about bringing up sex, sexual health and sexual function with your medical team. Your health care professionals care about you and your quality of life. They can help you or refer you to another professional who can.

Here are some ways to talk to your doctor about sexual health:

  • Prepare a statement for your doctor before your visit. It could be, “I have concerns about my sexual health,” or “I have symptoms I’d like to talk about.”
  • Be specific. For example, you can mention your level of interest in sex, or say if you have vaginal dryness or pain with sex.
  • Use resources. Magazine articles, stories from friends with similar issues or other related items can get the conversation going.

Self-reporting checklists

A number of checklists have been developed for use in cancer clinics. You can use these to self-assess and begin a conversation with your doctor. These are short surveys, typically beginning with a general question such as “Are you satisfied with your sexual function?”

What you can do right now

  • If you are having any sort of sexual issues related to your health conditions or treatments, make an appointment with your doctor. Use the tips above to start the conversation.
  • Communication is key, not just with your doctor, but your partner as well. Ask for what you need and share your feelings. Your partner may not be aware of changes you are experiencing.
  • Get creative with intimacy. Sex isn’t the only way to be close. Explore new ways to create intimacy with your partner.

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