Awkward Auntie Question No. 5

libido 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 have zero sex drive. None. My only desire to do it is so that my poor long-suffering partner isn’t doomed to a sex-free existence. How do I build this into my routine again? For a long time the act itself was very painful, now its less so but I just feel uncomfortable and unengaged.

Awkward Auntie: This is a common question; loss of desire (also called libido) is the most common complaint I hear in my therapy practice. Desire is a delicate thing and particularly in women, can be lost (and gained) with the slightest change in how we see ourselves, our relationship, if we’ve had a stressful day etc. It is VERY common for women who have gone through the kind of treatment you had to lose interest, and feel bad about it.

Our thinking about female desire has changed over the last 10 years or so. We used to assume that women, like men, should or do have feelings of desire all the time, what we call spontaneous desire…. but our more current thinking is that for many women, desire is REACTIVE, that is our desire kicks in once we become aroused (physically or mentally). So if you sit around waiting to feel spontaneous desire, you may be sitting around for a long time… So if your partner is understanding and patient, ‘fooling around’ with no end goal (sex) as the target may ignite your desire.

That said, you have been through a LOT – and the pain or discomfort you are left with will of course impact on your desire….the disengagement you describe may have something to do with the disengagement you had to take on to get through the treatments that are violating for many women. In order to be sexually responsive your head needs to be connected to your body and sensations – this is the OPPOSITE of what you needed to do when going through treatment! Using a good lube may help with some of the discomfort as radiation dries out the tissues and you may need some local estrogen as well.

Seeing a sexuality counselor who knows about cancer might be a good idea as well as seeing a GYN who knows about the treatment you have had.

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. 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