Sexual dysfunction/erectile dysfunction

Do not be afraid to discuss any sexual dysfunction concerns or problems with your doctor either during or after cancer treatment. Sexuality is an important aspect in your quality of life and it shouldn’t be ignored.

First, know that many cancer patients experience some form of sexual dysfunction following cancer treatment. This can be related to your ability to have sex or to enjoy it. Do you

• Have no desire for sex?
• Have physical problems such as erectile dysfunction, vaginal dryness or pain during sex?
• Are there concerns with ejaculation or urine leakage?

All of these should be discussed with your doctor.

In men, treatment for cancers such as prostate, bladder or colorectal cancers can increase the risk of erectile dysfunction and problems with ejaculation and urine leakage. Nerve-sparing surgical techniques have shown success in preserving erectile function. On average, if nerves aren’t damaged during treatment and there are no other co-existing conditions such as diabetes or vascular problems, up to half of all men who undergo surgery, brachytherapy or other radiation therapy will see improvement in sexual dysfunction within 1-3 years. For those who continue to have problems, oral medications, mechanical devices or penile implants are options to improve function.

Women who have undergone treatment for ovarian and other pelvic cancers can experience vaginal dryness, reduced sensations, inability to orgasm, or pain during intercourse as a result of hormonal changes or early menopause. Psychological factors such as body image also can lead to a lack of desire. Lubricants, muscle re-training and medications can address dryness and pain. Close communication with your partner and varied positions also can help.

If depression and anxiety remain after physical concerns are addressed, you should consider talking with a trained mental health professional. Through the Barnard Health and Cancer Information Center at Barnes-Jewish Hospital/Washington University School of Medicine, we offer free counseling services. To make an appointment, call (314) 362-7844.