Sex After Breast Cancer: Why Am I So Hesitant?
Breast Cancer: Sex and Intimacy
What are structured sexual exercises and behavioral modification?
Patients with sexual complaints are always encouraged to make lifestyle modifications. A well-balanced, nutritious diet combined with an active aerobic exercise plan is vital. In fact, vigorous exercise maybe linked to decreased cancer recurrence. Stopping the use of tobacco and illicit drugs, combined with minimizing alcohol consumption, is also encouraged. Take frequent naps, and plan sexual intimacy when you are well rested. Sexual intimacy needs to be a priority for you and your partner. Set limits on other commitments such as employment, social responsibilities, and family obligations. Technology, such as cellular telephones, iPhones, Blackberries’, pagers, and laptop computers, often interferes with private time. If you are preoccupied with these devices, you may be suffering from a soft addiction, which can limit intimacy. Limit the use of these devices to a specific time so that they do not hinder sexual intimacy and interpersonal communication.
Similarly, patients may be given specific sexually structured tasks designed to identify and help with specific sexual complaints. Some examples of behavior modification sexual techniques include the following:
- Erotic reading (try reading a racy erotic novel in a quiet, relaxed place!)
- Sensate focusing (concentrate on your physical sensations, notice what feels good when you’re intimate with a partner
- Squeeze-stop technique (alternately tightening and relaxing your pelvic muscles), and stimulation to control ejaculation
- Guided imagery (imagining a particular scenario)
- Relaxation techniques (rhythmic deep and shallow breathing exercises)
- Exploration of sexual fantasies (using props, sexual accessories, or mental imagery)
- Masturbation
Many patients are asked to perform sexual exploration, including nongenital touching and self-stimulation exercises, to improve and enhance sexual self-esteem. Patients and their partners are educated through use of open discussions concerning mutual massage, intimate fondling and caressing, or manual, digital, or oral and anal stimulation.
Let your imagination be your guide. Patients and their partners may also be encouraged to engage in alternative sexual positions. Most couples engage in intercourse in the missionary position, which facilitates deep penetration and thrusting. This position, however, can be very painful for the woman who has a shortened vagina in association with vaginal and vulvar atrophy or can place unwelcome pressure on a postoperative surgical site on the chest. Sexual intercourse in alternative positions may include side to side (spooning) or female superior positions, which may help limit deep pelvic thrusting. Other sexual positions encourage direct clitoral stimulation, which greatly facilitates arousal in many women. If movement and mobility are issues (e.g., chronic arthritis, bone and/or joint illness), you can use pillows or down comforters to help create a comfortable sexual environment.
Tantra
Is the ancient Indian spiritual tradition and belief system that sexuality is tied to personal energy. It is focused on changing the focus of sexuality from a carnal activity to spiritual enlightenment. Maintaining control and heightening spiritual awareness become the goals of sexual intercourse. When incorporated into lovemaking, the techniques ultimately intensify the couple’s sexual dynamic or consciousness. Sexual enhancement, pleasuring, living consciously, and the various postures of lovemaking are important tenets of Tantra. The union of the yin and yang (the male and female) expands the dimensions of sexuality, and through the control of orgasm, feelings of intimacy and connectedness with your partner are ultimately enhanced.
Pain
When pain is low and fatigue is minimal, sexual expression should be encouraged. Techniques such as warm soaks, physical therapy, and stretching exercises help to loosen tense muscles. Guided imagery, meditation, deep muscle relaxation, and avoidance of exhaustion are also options. Specifically trained pain management specialists can adjust or reduce opioid regimens, add adjunctive or alternative analgesics, and modify existing dosing schedules, lessening fatigue while maintaining sufficient pain relief.
Sexual Education
Women often are not educated about sexual responsiveness and their genital anatomy. Understanding these will help you know your normal physiological response and how arousal occurs. Examine you genitals with the aid of a hand-held mirror and the assistance of a healthcare professional. Do you know where the clitoral tissue is located? Comprehensive sexuality education may consist of take-home items such as pamphlets, books, videos, and other visual aids. Many widely published resources are available. Many women may opt to search the Internet. The International Society for the Study of Women’s Sexual Health, the North American Menopause Society, and the American College of Obstetricians and Gynecologists all maintain wonderful information on their websites about sexual health and education. They also provide medical information about the latest updates on female sexual therapeutics. For the female cancer survivor, the American Cancer Society’s booklet Cancer and Sexuality is an excellent reference guide that provides helpful suggestions (contact your oncologist)
Magnolia Myrick:
Beware of packaging labeled “natural” and “healthy” because a lot of it is bogus. Educate yourself about reading labels and about nutrition in general. Good information about nutrition is helpful, and it is empowering! It’s hopeful.
What is sensate focus?
Sensate focus is a term associated with a set of specific sexual exercises for couples or for individuals. It is aimed at increasing personal and interpersonal awareness of our own and our partner’s sexual needs. Each participant is encouraged to focus on their own sense experience, rather than to see orgasm as the primary goal of a sexual encounter. A sex therapist will usually guide the timing and technique of the sensate focusing. In the first stage, the couple is instructed to set aside dedicated time each week to touch each others’ bodies, excluding breasts and genitals. They are encouraged to enjoy and become increasingly aware of the texture and other qualities of their partner’s skin. Intercourse and focus on the genitals are disallowed. Participants concentrate on what they find interesting in the skin of the other, not on what they think the other may enjoy. The second stage of sensate focus increases the areas touched to include breasts. Sensation and gathering information about the partner’s body is encouraged, whereas intercourse and touching of the genitals are discouraged. The partners use a “guiding” technique of placing their hand over their partner’s hand in order to show what they find pleasurable in terms of pace and pressure. Learning about the partner’s body, rather than pleasure, is still the goal. Nonintercourse aspects of sex are explored: touching, tasting, hugging, and kissing. Partners are encouraged to talk to each other, to express emotion, and to encourage one other. Further stages include the gradual introduction of genitals and then full intercourse; however, intimacy and pleasure, rather than orgasm, remain the primary focus of the couple’s interaction. Sensate focus techniques are used for increasing sexual arousal and interest and also as a treatment for sexual dysfunction, especially in sexual difficulties where fear and anxiety are involved.
The aim of sensate focus treatment is to develop an appreciation for an array of sensual possibilities, leading to a reduced concentration on the mechanics of intercourse. Women typically report improved sensation, arousability, and lubrication. Couples often report an improvement in their sex life with less anxiety and greater intimacy.
Is it normal to feel uneasy about reading erotic literature?
Many women feel uneasy about reading erotic fantasy literature or viewing sexually explicit films (“porn”) to enhance sexual feelings. They may believe that when they read about or view variations in sexual expression or think about sexual activity with a different partner, they are disrespecting or being unfaithful to their “real-life” partner. Fantasy does not necessarily represent one’s desire for reality but is simply a means to stimulate parts of the brain where sexual thoughts and behavior originate. Research by world-renowned sexual expert and psychologist Julia Heiman PhD, Director of the Kinsey Institute, suggests that exposure to erotic stories can be a powerful catalyst for a genital engorgement (blood flow, swelling, lubrication) and arousal in both men and women. Research published by the Sinclair Institute (producers and distributors of erotic films for couples) suggests that female study subjects report increased sexual desire, arousability, and ease of orgasm after viewing erotic scenarios compared with women who viewed sexually neutral films. By considering the use of sexually oriented literature and films as a “self-help” method for sexual vitality, perhaps you can reframe what may have been seen initially as an uncomfortable or shameful activity as a healthy and growth-promoting experience. Discuss exploring sexual erotica with your partner and see whether you want to explore this new dimension of sexuality! Look at the Sinclair Institute’s website (www.sinclairinstitute.com), and order some sexual accessories or videos today-it is a safe, discrete website that can enhance and spice up your sexual life.
Terms:
Soft addiction – Soft addictions are seemingly harmless habits like over shopping; overeating, watching too much TV, surfing the internet, that keep you from the life you actually want.
Masturbation – The act of self pleasuring; also known as self stimulation.
Tantra – An ancient Indian spiritual tradition and belief system with the premise that sexuality is tied into personal energy and is capable of changing us if we submit to our primal sexual desires while maintaining control and heightening spiritual awareness. Tantra can intensify lovemaking and intensify the sexual dynamic or consciousness between couples.
Sensate focus – A term used to describe a set of sexual exercises for couples or individuals. These exercises are aimed at increasing personal and interpersonal awareness of both our own and our partner’s sexual needs.
Erotica – Sexually themed works such as books or sculpture deemed to have literary and artistic merit. Naked men, women, or other body parts are often featured as predominant themes.
Fantasy does not necessarily represent one’s desire for reality but is simply a means to stimulate parts of the brain where sexual thoughts and behavior originate.
