Awkward Auntie Question No. 4

libido after cancer

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Q: I am a woman. I used to have a very satisfying sex life and high libido. Because of breast cancer I had to have a double mastectomy (no more nipples and no sensation). Then chemo put me in menopause. I am not allowed to take replacement hormones as my cancer was estrogen positive. I feel like I have been “castrated” – doctors don’t tell you your clitoris will shrink, your vaginal canal will shrink and become rigid. I have zero interest in sex (pain plus no libido, plus the several times I have been able to have some kind of an orgasm it has been so weak I barely noticed it), I am single and still young. What can I do? Is there a way to rehab the body?

Awkward Auntie: This is a long and complex answer because this is a complex situation. Chemotherapy causes menopause in women and it is usually way worse than ‘normal’ menopause. Many oncologists will prescribe local estrogen for women like you as the systemic exposure is minimal. This is the only thing that will really help with the dryness and shrinkage that you describe. I believe that it is a woman’s choice whether she wants to use this or not and not the decision of the oncologist to refuse to talk about it. You can try using vitamin E oil on the vulva for daily comfort and you must use a good water or silicone based lube for any kind of penetration. Find one that has the least amount of ingredients – silicone lubes often have just one or two ingredients. Using an external vibrator to ramp up your arousal response and use it often. This takes time and patience… but your body can relearn to feel pleasure and that will increase your libido. But the reality is that things are not going to be as good as they were before because so much has changed. There is no magic recipe or rehab – but time and exploration can open new avenues for sexual pleasure.  The following is a good resource too!

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.

Awkward Auntie Question No. 3

sex with one testicle

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Q: Can a person still have sex after an orchiectomy?

Awkward Auntie: The short answer to this is “yes!”. A testicle (ball, nut – whatever you call it) is not essential for sex. Losing one testicle will not affect anything related to sexual functioning but some guys may experience changes to their body image if they are not given a prosthesis (artificial testicle placed into the scrotum). This is usually done at the time of the removal of the original testicle.

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer* – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.

Awkward Auntie Question No. 2

dating after young adult cancer

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Q: I had acute lymphocytic leukemia as a toddler. I’m now 23 and healthy. I have a little scar on my chest from a surgery. I get questions about it when I’m at the pool or with a new partner. How could I best answer/deflect questions without making things awkward or ruining the mood? I don’t remember much of my treatment since I was so young, it’s always uncomfortable for me to explain. I usually say “I had surgery when I was little…” or “I had cancer when I was really little, but I don’t remember it” etc. (23 year old man.  ALL)

Awkward Auntie: Thanks for this great question. It sounds like you have dealt with this in a really good way. Just stating the facts without going into a whole long story is the best way to deal with questions like these. If the other person wants more details they’ll ask for them or they’ll just move on to something more interesting to talk about. You don’t even have to say ‘cancer’ … just stating that you had surgery when you were little and you don’t remember it is truthful and probably all that others need to know.

One way to deal with discomfort is to make a joke about it. “Oh this little scar? Small Game of Thrones accident” might work if you’re a GOT fan. Or perhaps “Oh that’s where Cupid’s arrow pierced me the moment I saw you”….

Some people get a tattoo to cover up the scar – but you have to find a tattoo artist who knows how to work with scars.

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer* – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.

Awkward Auntie Question No. 1

dating after aya cancer

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Q: I had cancer 3 years ago and look pretty ‘normal’. When should I tell a guy about my cancer? I’ve told only one guy who I really liked and after that, I never heard from him again. (23 year old woman. ALL)

Awkward Auntie: This is probably the most challenging question to answer because it all depends! There are risks to telling on the first date – the guy may bolt in shock or decide that this is too much to handle. Leave it to the third or fourth date and it may feel like you are hiding something. Maybe the second date, if there is a second date, is a good time to disclose. There’s more interest than a first date but you are not as invested as you might be on the third date or beyond.

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer* – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.

Welcome to Awkward Auntie by Dr. Anne Katz

sex after cancer

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really need the answer?  Now you can ask those questions and get answers!

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer* – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to AwkwardAuntie@lacunaloft.org or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.

Send your question to AwkwardAuntie@lacunaloft.org or submit them in the form below and watch this space for the answers.

*This Should Not Be Happening: Young Adults with Cancer

Let’s Talk About Sex

sex after young adult cancer

This post is brought to us by Jennifer!  If you missed her interview with Lacuna Loft, you can find it here!  You can find all of her posts here.

“Let’s talk about sex, baby. Let’s talk about you and me. Let’s talk about all the good things and the bad things that may be… let’s talk about sex.”

– Salt N Pepa, “Let’s Talk About Sex”

The speed at which your head spins upon getting a cancer diagnosis eventually stops. You right your course; you hold your head up and barrel through invasive tests, treatment and surgeries. You may lose body parts. You may go into ‘I don’t care just get it out of me’ mode. You may cry, break things, and climb under the covers for as long as you can withstand not having to eat or pee. It’s all normal and it’s all okay. There is no right or wrong way to deal with cancer. There will be a time when you catch a glimpse of your pre-cancer life after the haze of treatment. Maybe you’ll go shopping or out to lunch. Perhaps you’ll make time for a quick mani-pedi with a friend or enjoy the solitude of sipping a cup of coffee alone in a café. In pieces, it comes back; a subtle reminder of the complete person you were pre-cancer. But in the trenches of treatment we may forget, in addition to human beings, we are intimate sexual beings as well. That is typically the last piece of the puzzle to fit into place.

The words sexuality and cancer, when used together, are an oxymoron. How can you possibly feel desirable, or attractive when you’ve been chopped up and put back together? As a breast cancer survivor I frequently refer to my Franken-boobs, for they are unlike any other body part I was familiar with. They feel numb, alien, foreign and far from sexy, trust me, they are just for looks. Add to the extensive surgical recovery the indignities of chemotherapy: nausea, mouth sores (and sores in other areas where you have mucous membranes … wink, wink) and both diarrhea and constipation. If you need radiation you may have to deal with extreme fatigue and often painful burns and blisters. Good times? No. Sexy times? Not even close. But one thing I realized during my first visit to Cancertown is that intimacy is even more important than sexuality. If you are as lucky as I am to have a kind and extraordinarily patient partner, you realize that way, way, way before the physical must come the emotional. Being intimate with someone is so much more than a bump and grind between the sheets.

When I was in active treatment my husband and I set up a routine, which, unbeknownst to us, built intimacy. While I was on disability the first thing we would do in the morning was go for a long walk at a local park. Sometimes holding hands sometimes not. There were times I wanted to be touched and times I needed to be self –contained, he respected that boundary. We would frequently grab a coffee and a bagel on the way to treatment (I found heavy starchy carbs to be great at keeping the nausea at bay). After treatment, if I felt well enough, we would go for a light lunch. We would sit across from each other in a booth, sometimes talking, sometimes reading the newspaper, sometimes doing the mundane like paying bills or making the week’s shopping list but we sat there, together. That’s intimacy. Once the hard-core chemo was done, and my appetite back to normal I still had to contend with my monthly Herceptin infusions. I would schedule them for late morning so that we could have our Herceptin lunch dates, afterwards. We were side by side, together. It wasn’t a turn-on but it was intensely comforting. I set the pace and the boundaries and he respected that allowing intimacy to grow.

As my hair began sprouting and I lost that deathly pallor that cancer embedded into my skin I began feeling pretty good about myself. I could totally rock the buzz cut and cancer gave me a bit of swagger. I was a badass and I sure as hell worked it. My husband’s desire for me was always there … I just had to be ready to accept it. We started slow; there were many nights of simply snuggling, holding each other and talking. When I finally felt ready I asked my nurses for any tips and or tricks because my body, I could tell, was so different than it had once been. Their advice? “Oh sure honey, just use lube and protection.” Ummm, okay.

Armed with a vat of KY and a box of condoms I decided to tentatively step back in the sexytime ring, but within seconds my lady parts were screaming ABORT, ABORT, ABORT. See, my nurses never told me that using KY would be akin to sitting upon hot coals. So no. No sexytime for us that night.

When we were over the trauma of the fire crotch we tried again, but this time with coconut oil, which is truly the bomb-diggity! Was it great? No. Was it better than I expected? Yes. I felt a part of myself come back to life. We took time to build up the intimacy, which eventually bridged the gap, to desire, which then led to the good stuff. I got my groove back. We got our groove back. Then I found out I had cancer again.

This time my damn hormones were the driver, which meant after the bilateral mastectomy, after the DIEP flap reconstruction, after the drains, after the chemo and after the hair loss I was scheduled for a full hysterectomy. I was quickly being stripped of any and all femininity. Being put into chemical menopause twice before I even hit age 45 and then having all my lady parts removed was a real hit to my libido. All I could envision was myself quickly aging into a hairy, sexless troll. Sure I knew we had the tools from the first visit to Cancertown but could we do it again? Would I ever feel like an intimate sexual being again?

The short answer to that is yes. Like a camel that can go weeks without water while trudging through the hot dry sandy desert we, as sexual intimate human beings, can go quite a while without sexytime. The key is to build intimacy. Intimacy comes in many forms but at its root it’s about being together, communicating and understanding the boundaries and limits a loved one with cancer may be dealing with. It’s not easy and there is no set timeframe. Listen to your body and to each other. Remember, your partner may be terrified of hurting your newly scarred and reconstructed body as well. Talk through your fears and your feelings. Explain your needs and the ways your body has changed. Be honest and embrace each little pre-cancer piece that returns after the long dry spell.

5 Tips For Navigating Sex And Intimacy After Cancer

sex and intimacy after cancer

There are many physical and emotional changes after cancer that can affect sex and intimacy. Read more on ways to cope with and embrace this new normal in your bedroom.  This post is for the ladies out there!

They are the words no one wants to hear: “You have cancer.” As you begin your journey of doctor visits, medications, and a seemingly never ending treatment plan, your mental health takes a turn. Then soon after, you realize that your sexual health may also take a hit – even though nobody really mentions it. Between medications, chemotherapy, radiation, hormonal changes, and surgeries, you start to feel disconnected from your body. Along with losing your hair and supple skin, you also feel a loss of femininity. I’ll pause right now to tell you: you’re not alone.

You’re not alone when you stare in the mirror, trying to understand what has happened to your body as you see a different woman. If you are a breast cancer survivor in particular, you may see scars where you once had nipples, expanders where you once had breasts, a beanie where you once had hair. You’re not alone when tears roll down your face as you turn away from the mirror, no longer able to look. I know that even just the thought of being touched is very difficult, and how difficult it is for your partner, who doesn’t want to do anything that will upset or hurt you.

Your partner still has his or her sex drive, still finds you attractive, and still wants to be intimate with you, but how? You have no sex drive, you’re as dry as the Sahara desert, and you no longer have sensation in certain areas.

Your “spot” was once your nipples. That’s what turned you on! Now what? How can you be aroused and reach orgasm without nipple stimulation? On top of that, you feel embarrassed, self conscious, and unattractive. Once you’re finally aroused, you face another roadblock- you’re unusually dry. You may feel like all hope is lost.

Some common sexual function concerns after cancer include loss of desire, negative body image, depression, painful intercourse, loss of sensation in certain areas, vaginal dryness or tightness, and failure or difficulty to reach orgasm. For the last 11 years, I have been hosting workshops on Intimacy After Cancer. I realized how important a woman’s body image is to her and how much treatment and effects of treatment can cause issues in their intimate life and compiled a few tips that can help you find your “new (sexual) normal.”

But first, if you are still in treatment, before engaging in sexual activity, make sure you talk to your doctor about any sexual restrictions. If you aren’t sure how to talk to your doctor about sex, here are some great tips for initiating that conversation.

1. Try a vaginal moisturizer.
If you are experiencing vaginal dryness, you can try a vaginal moisturizer. Depending on your cancer diagnosis, you may need to stay away from estrogen. Your doctor may prescribe you something, or you can see if estrogen-free products like Replens seems like a fit for you!

2. Use a lubricant.
Pure Romance has two great lubricants that you can add into your sexual experience. You can opt for a paraben-free, all-natural lubricant, such as Pure Naked Lubricant, or a water-based, pH balanced lubricant. I recommend using a combination of the two. Moisturizers are for maintenance and lubricants are used during intercourse or with bedroom toys.

3. Have fun discovering your new “hot spot”.
Your nipples may have been your previous “spot,” but you are a new and improved woman. Explore different erogenous zones and have fun finding your new “spot” with your partner!

4. Use a heightener.
There are products on the market that help to provide a heightened sexual experience, help with arousal, and help you to reach orgasm. Depending on your sensitivity, you may want to opt for fragrance free products.

5. Use a vaginal dilator.
Your doctor may have recommended a dilator, but you couldn’t bear using a device that looked like what you see at your gynecologist’s office. Here is a vaginal dilator that is pleasing to the eye and will help decrease discomfort during intercourse.

 

The good thing is that most, if not all, of these side effects are temporary. In the meantime, adapt to your new “normal.” Be willing to accept your changes and move forward. Being intimate with your partner will come when you are ready. You may be ready immediately or you may want to wait a while, each person has their own journey. What is most important is that you keep the lines of communication open with your partner.

Do you have any other tips? Share them in the comments below.

Welcome Natalie!

Lacuna Loft is excited to continue introducing more young adult voices! These great folks represent a variety of perspectives on the myriad of topics covered here at Lacuna Loft. Before everyone starts really getting into the nitty-gritty of all they have to say, we wanted to introduce them a bit. Without further ado, here is Natalie!

Natalie is a sexuality educator and mentor with a Masters in Psychology, sex toy peddler, speaker, blogger, and event organizer in South Florida. She offers empowering education for women through her wide variety of transformational, inspirational, and practical teachings. She has over 12 years of experience working one on one and in group settings, educating women on intimacy and sexual health.

Natalie is also the founder of an online program Reconnect, Restore, Reclaim; a Holistic Approach to Intimacy After Cancer. She can be seen in ihadcancer.com. beatcancer.org, noumagazine.org, and more. She has also appeared on multiple podcasts, blogtalks, and video interviews.  You can check out her website, here.

Dating During And After Cancer

dating after cancer

So many young adults face a cancer diagnosis while they are single or dating someone.  This leaves the likelihood of dating during cancer.  We’ve picked a few articles from the interwebs with a variety of perspectives on dating with cancer.  Hope you enjoy the dating and young adult cancer link round up!

[list type=”like”]
[list_item]#YAPchat: Dating, relationships, and cancer[/list_item]
[list_item]Dating After Cancer Was Way Less Fun Than It Sounds[/list_item]
[list_item]Generation Why: Dating…With Cancer[/list_item]
[list_item]Back In The Game: Dating After Cancer[/list_item]
[list_item]Dating After Cancer[/list_item]
[list_item]Would You Date A Cancer Survivor[/list_item]
[list_item]When Do I Tell Her?[/list_item]
[list_item]Dating After Cancer[/list_item]
[list_item]8 Things to Consider When Dating After Cancer[/list_item]
[list_item]Dating After Breast Cancer…With No Nipples[/list_item]
[list_item]By The Way, I Have Cancer[/list_item]
[list_item]If You Think “Normal” Dating Is Hard, Try Dating After Cancer[/list_item]
[/list]

Interested in writing with Lacuna Loft about your own dating during cancer experiences?  Email us at info@lacunaloft.org!

Rethinking Body Image: Remember To Love Yourself

body image after cancer

This post is brought to us by Clarissa!

It was recently Valentine’s Day and while the day is meant to share love with others, I also think it’s a great time to remember to love yourself.

When I first started going on dates and had my first relationship (which wasn’t until sophomore year of college), I was incredibly nervous. Not only was I late in the game compared to many of my peers, but I was also incredibly self-conscious. Sure, I had the same questions running through my head that most girls consider – does he really like me, does he think I’m pretty, will he ask me out again? But, the nerves really came from the fact that I simultaneously contended with some more serious questions, ones that most girls don’t have to worry about – is he going to be grossed out if he sees my scars, does seeing my scars mean I should tell him I had cancer twice, and what should I do about the stretch marks (caused by all the steroids I took during treatment) that cover my lower abdomen and lower back?

Before I knew it, the normal questions had spiraled into this realization that I found fault with my body for things that could not be changed. I had not accepted those parts of me, so how could I expect someone else to?

Often, we think only of body image in relation to cancer treatment, considering how the impact of hair loss, weight gain, weight loss, surgery, etc. can all take a toll on the body. However, I think body image is equally as challenging after cancer treatment, when the rest of your life is back to “normal” but your body doesn’t catch up and is not what it once was. To some extent, you can work to restore your body’s health by eating well and exercising regularly. But, there are often things that you can’t do anything about.

How can you learn to accept those things you can’t change? I’ve learned that a lot of it has to do with perspective. You don’t have to think of scars, stretch marks, etc. as faults. Rather, think of those things as strengths. They are signs that your body got through things most other bodies don’t have to do. Find empowerment in them. I found this change in perspective gave me a big self-confidence boost and enabled me to view myself in a much more positive way. Maybe it can do the same for you 🙂

How do you conquer self-love and self-image?  How have you dealt with body image after cancer?

Clarissa Schilstra is a two-time cancer survivor. She was diagnosed with acute lymphoblastic leukemia for the first time when she was two and a half years old. She went through two and a half years of chemotherapy and survived. She led a happy and healthy life until June of 2007, when her cancer relapsed. So, she went through another two and a half years of chemotherapy, this time accompanied by radiation. She is now twenty-one years old and a senior at Duke University. Her passion is helping others cope with the ups and downs of life during and after cancer treatment. It is her goal to become a clinical psychologist after she graduates from Duke, and she would like to help improve the psychological care available to adolescents and young adults who have serious illnesses. You can read more about Clarissa on her website and blog at www.teen-cancer.com. You can also find her book, Riding the Cancer Coaster: Survival Guide for Teens, on Amazon.

Interested in contributing a one-time article to Lacuna Loft? Email info@lacunaloft.org with your submission!