If you are experiencing a sexual problem as a result of cancer treatment, you might find it helpful to:
- Discuss it with your doctor and other members of your health care team.
- Request a referral to a specialist in sexual problems.
Many health care professionals, including doctors, have little training in sexuality problems. They may not be at ease even talking about sex. Doctors may fail to mention the sexual side effects of cancer or of medical treatments. Also they may provide such a sketchy picture that you may conclude that your sex life would be over. If your cancer specialist can't help you, we suggest you ask your family doctor or other members of your health care team. If your doctors cannot give you a referral, a number of different programs and specialists often help. Programs and specialists for sexual problems include:
- Sexual rehabilitation programs in cancer centers: These centers for treating cancer may have experts on staff who can evaluate and treat a sexual problem. However, often these specialists see only patients who are being treated for cancer at their hospital. If you are being treated at a cancer center, check to see what programs are offered.
- Sexual dysfunction clinics: Comprehensive clinics to treat sexual problems exist at medical schools and private practice groups. Such clinics often provide both psychological and medical exams and treatments. The clinic staff may include psychologists, psychiatrists, social workers, urologists, gynecologists, endocrinologists, or specialists who run a sleep laboratory. Some clinics require both sexual partners to participate in the evaluation, though you may be seen alone if you are not in a committed relationship. Some clinics offer a more complete range of services than others.
- Sex therapy: Sex therapy is a brief type of psychotherapy (usually 10 to 20 sessions) focused on solving a sexual problem. Sex therapists believe that lovemaking skills are learned and that bad habits can be corrected by learning sexual techniques. In between meetings with the therapist, a couple (or sometimes just a man or woman treated alone) is given "homework" assignments. The homework consists of exercises to develop better communication and more enjoyment of touching. It also reduces anxiety that interferes with good sex.
Sex therapists may practice in the clinic or independently. Because most states have no laws regulating the title "sex therapist," a person with no formal training can often call themselves a sex therapist. A sex therapist should, however, be a mental health professional (psychiatrist, social worker, or psychologist) with special training in treating sexual problems with sex therapy. Some nurses or counselors may provide sexual counseling if they are supervised by a licensed professional.
Professional societies, such as the American Association of Sex Educators, Counselors, and Therapists (AASECT), can give you information about their members who practice in your area, although many competent sex therapists do not belong to these organizations. You can also get a listing of professionals in your area who have specific training in sex therapy by contacting your state's psychological association, a chapter office for the National Association of Social Workers, or state association for licensed Marriage and Family Therapists.
Other Kinds of Counseling
Psychotherapy can allow you to feel better about the changes in your body, help you improve communication in your relationship, or give you skills to cope more easily with the cancer.
Finding a well-qualified mental health professional is important:
Psychiatrist: a medical doctor specializing in mental health and behavioral disorders. Psychiatrists provide counseling and can also prescribe medications.
Psychologist: a health professional who assesses a person's mental and emotional status and provides counseling.
Social Worker: a health professional who helps people find community resources and provides counseling and guidance to assist with issues such as insurance coverage and nursing home placement.
The expense of counseling varies with the professional's training. One way to get quality treatment for a lower fee is to find a nearby medical school with a psychiatry clinic. You can also go to a university that trains clinical psychologists and has a psychology clinic. A student in advanced training will see you, but she or he will be supervised by a senior professional.
Other Medical Specialists
Gynecologist: If you have sexual problems, you should be examined by a gynecologist, a doctor experienced in treating diseases of the female genitals and reproductive organs. A very thorough and gentle pelvic exam is very important when a woman has pain during intercourse.
Endocrinologist: A doctor who specializes in diseases related to the glands of the endocrine system, for example, the thyroid, pancreas, and adrenal glands. When the most likely cause of a sexual problem is a hormone imbalance, an endocrinologist should be consulted. Endocrinologists are expert in the complex cycles and systems that control hormone levels. Usually your primary doctor is best able to decide whether the special knowledge of an endocrinologist is needed to solve your problem.
What to Avoid
There is no evidence that any of the following can cure a sexual problem:
- Potency pills, such as "poppers" or "Spanish fly"
- Oysters
- "Exercisers" that fit inside a woman's vagina
- Hypnotism by someone not trained as a mental health professional
- Visits to an independent "sexual surrogate"
Pursuing such useless treatments not only wastes your time and money but can sometimes be harmful.
RESOURCES
Other Organizations
The Susan G. Komen Breast Cancer Foundation
Toll Free Number: 1-800-IM-AWARE
Internet Address:www.komen.org
Y-ME National Breast Cancer Organization
Toll Free Number: 1-(800) 221-2141
Internet Address:www.y-me.org
Y-ME Spanish Language Hotline
Toll Free Number: 1-(800) 986-9505
American Association of Sex Educators, Counselors and Therapists (AASECT)
P.O. Box 238 Mount Vernon, Iowa 52314-0238
Internet Address:www.aasect.org
The International Association of Laryngectomees (IAL)
Telephone Number: (866) 425-3678 / (209) 472-0516
Internet Address:www.larynxlink.com
Let's Face It, Inc.
Telephone Number: (360) 676-7325
Internet Address:www.faceit.org/letsfaceit
The Leukemia & Lymphoma Society
The Telephone Number: (914) 949-5213
Toll Free Number: 1-(800) 955-4572 (Information Rescue Center)
Internet Address:www.leukemia-lymphoma.org
National Cancer Institute(NCI) NCI Public Inquiries Office
Telephone Number: (301) 435-3848
Toll Free Number: 1-(800) 4-CANCER (1-(800) 422-6237)
Internet Address:www.nci.nih.gov
National Coalition for Cancer Survivorship (NCCS)
Telephone Number: (301) 650-9127
Toll Free Number: 1-(888) 650-9127 / 1-(888) 622-7937 (for material orders)
Internet Address:www.cansearch.org
United Ostomy Association, Inc. (UOA)
Telephone Number: (949) 660-8624
Toll Free Number: 1-(800) 826-0826
Internet Address:www.uoa.org
Additional American Cancer Society Information
Books on Women's Sexuality
- Barbach L. For Yourself: The Fulfillment of Female Sexuality. New American Library, 1991. (Self-help guide for women having trouble reaching orgasm. Paperback.)
- Boston Women's Health Book Collective. Our Bodies, Ourselves for the New Century: A Book by and for Women. New York: Touchstone Books, 1998. (Comprehensive information on women's health, including sexual physiology and sexuality. Paperback.)
- Cutler W, et al. Menopause: A Guide for Women and Those Who Love Them. Cambridge: W.W. Norton & Co., 1993.
- Dennerstein L, et al. Hysterectomy: New Options and Advances. New York: Oxford University Press, 1999. (Facts on adjusting to hysterectomy, although not necessarily as treatment for cancer. Paperback.)
- Heiman J, and LoPiccolo J. Becoming Orgasmic: A Sexual and Personal Growth Program for Women. New York: Simon & Schuster, 1988. (Comprehensive information on women's sexuality. Paperback. Companion videotape also available, see Videotape section.)
- Siegal D, Doress-Worters P. The New Ourselves, Growing Older: Women Aging with Knowledge and Power. New York: Simon and Schuster, 1994.
Books on Men's Sexuality
- Bostwick DG, MacLennan, GT and Larson, TR. Prostate Cancer: What Every Man "And His Family" Needs to Know (Revised). New York: Villard Books, 1999.
- Zilbergeld B. The New Male Sexuality: The Truth About Men, Sex, and Pleasure. New York: Bantam Books, 1999.
- Korda M. Man to Man: Surviving Prostate Cancer. New York: Vintage Books, 1997.
Revision date: 2/9/01
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