Sex after an ovarian cancer diagnosis

If you have been diagnosed with ovarian cancer, you may be wondering how it will affect your sexuality and sex life.

Guest blogger Emily Gunning from Live Better with Cancer has written a guide to help women feel more confident when navigating the often-tricky territory of sex following preventative surgery or a cancer diagnosis.

1. Can people with cancer still have sex?

Yes! Not everyone with cancer will see changes in their sexual desire or how they feel about themselves sexually. You might not notice any changes at all. 

However, cancer can potentially have a big effect on your sex life, and things might change physically and emotionally. You might not have any interest in sex during cancer treatment – this is totally understandable, and should be respected by your partner. But equally, a cancer diagnosis doesn’t have to mean a life of celibacy. Just like sex without cancer, it’s a case of figuring out your boundaries and limits; what you and your partner are comfortable with; and what feels good.

Another way of feeling closer and re-establishing intimacy with your partner during cancer is to do small, intimate acts for them, without expecting anything in return. Setting up a relaxing atmosphere with some scented candles, giving your partner a foot rub with some luxury lotion, or a shoulder rub with some massage oils that won’t irritate their skin – all of these things can help to build closeness and intimacy between partners who feel pushed apart by cancer.

2. Overcoming feelings of self-consciousness during sex

Everyone's relationship with their post-surgery body is different. There are lots of amazing women who wear their scars – and the stories they tell – with pride. However, it is also very normal to feel self-conscious about the scars you have from the procedure, which may lead to feelings of self-consciousness about sex.

One way to accept and adjust to these feelings might be to agree with your partner that they will avoid touching this area. You could also try wearing some clothing in bed that conceals your scars. 

If you want to overcome the issue more comprehensively, you could work towards touching the scars yourself, and asking your partner to reassure you that they still find you (and your breasts) beautiful, scars and all. If you feel comfortable with the idea, you could even try some lingerie designed to comfortably conceal mastectomy scars (not every post-surgery bra is flesh-coloured and clinical-looking, and some are pretty sexy!).

Some or all of these solutions might help you to feel comfortable with intimacy at different times. Discovering what works in your relationship will require talking about your feelings openly and honestly.

3. Is it safe to have sex during chemotherapy?

It is not known for sure whether or not chemotherapy drugs can be passed on through secretions from the vagina. However, to be on the safe side some doctors advise patients to use a barrier method (such as condoms, femidoms or dental dams) if you have sex during treatment.

Generally, doctors advise a barrier method only for the time you are actually having the treatment and for about a week after your treatment. 

However, one thing to note: whether you’re using condoms or not, you should always use some form of contraception for the whole duration of chemotherapy in order to prevent pregnancy, as chemotherapy drugs can affect foetal development and result in serious birth defects.

Talking to your doctor about how to time your sexual activity is your best bet – they’ll know the half-life of the specific drug you’re taking and will be able to advise you on how you and your partner can have safe sex during chemo. It might feel awkward to discuss sex with your doctor, but they’re used to hearing all sorts of things, so nothing you ask can surprise them. Remember that sex and intimacy are a very normal part of everyday life, and there’s no shame in getting the information you need.

4. Sex after hysterectomy and other surgeries

A range of surgeries can affect the vagina, such as hysterectomy (removal of the uterus) and oophectomy (removal of the ovaries). These surgeries can result in scarring, soreness and loss of sensation. Having your ovaries removed also triggers the menopause, regardless of age, which can lead to decreased libido, vaginal dryness and changes in appearance that might affect your confidence.

Sex after hysterectomy or oophectomy might be scary to think about at first, but once you’ve recovered from surgery, you should be able to have sex if you want to. Doing exercises to strengthen your pelvic floor muscles, taking hormone treatments to help with menopausal symptoms, and talking to someone about your feelings after the operation are all things which can help you to enjoy sex again. 

5. Dealing with vaginal dryness

Usually, when you’re aroused, the vagina produces natural lubrication that helps sex to feel good. There are hundreds of reasons this can go wrong even if you’re not living with cancer. Dryness can be caused by infections or using the wrong soap. If you are living with cancer there are a few extra reasons that you may be experiencing dryness. As well as gynaecological surgeries and menopause, chemotherapy and other treatments can cause vaginal dryness. If your vagina feels drier than usual, or you have problems with lubrication during sex, a sensitive, non-irritant lubricant will be your new best friend. Sex without proper lubrication can be really uncomfortable and even painful, so please don’t suffer in silence!

Lubricants are a gel that you can apply before and during sex, and they can be used externally or inserted with a small applicator. Though they’re associated with sex, if you’re experiencing vaginal dryness it’s a good tip to apply an internal lubricant (with an applicator) on a more regular basis; and even daily. Think about it like moisturising your face, just in a more private area; you’d moisturise your face more than once a week if you were experiencing dry skin!If the outside of your vaginal area (vulva) is uncomfortably dry, there are also sensitive vulva moisturisers available which can help to soothe sore skin and increase sensation in that area.