Cancer and Women’s Sexuality: Here’s what an acupuncturist wants you to know

Let’s start off by clearing the air here. You have NO obligation, to anyone, to fit into any societal standards or expectations of sexuality – whatever those may be. There are no specific beliefs, acts, or way of presenting yourself that you need to attain in order to be or feel sexual. Your sexuality and the way you inhabit your body is yours, and yours alone.
 
One of the more common reasons people want to connect, or re-connect, with their sexuality is because they want to feel like they did ‘before.’ Before their health changed. Before the diagnosis. Before rushing around to appointments. Before their personal life took a back seat, and along with it, their sexual energy and empowerment.

There is also often pressure – from society, from family, and from ourselves – to get back to who we were ‘before.’

So we’re just going to stop that. Right now. Regardless of what we’ve gone through or what we will go through, we are not meant to be the same person we were in the past. We’re not even the same person we were yesterday. And this is a phenomenally beautiful thing! Because no doubt, we’ve also changed in positive ways, even if we haven’t recognized it yet.
 

So what impacts our sexuality and libido, when it comes to navigating cancer diagnosis and treatments? We’re going to explore just a few common issues that might be keeping you from living your best life in the bedroom.

How does cancer affect sexuality?

The first, and most detrimental thing when it comes to sexuality in many cancer treatment settings is a general lack of conversation around the topic.

When undergoing intensive medical treatment, it becomes very easy to assign priority to discussions around important, albeit quite dry, matters. This is completely understandable. It’s important to be informed of your treatment options.  It’s important to know what side-effects you could be dealing with and what you can expect moving forward.

But the conversations about how your sexuality might be affected and why, and what you can do to improve it, just don’t seem to be happening as often as they should be.

If we’re not talking about these very real and valid concerns, then they go unaddressed.

You may not know who to speak to, or how to even start the conversation. The result is feeling like it’s just another unfortunate side-effect that must be accepted and ignored… as if it isn’t an important aspect of their health. Which simply isn’t true!

According to a 2016 study, sex can help to support your physical and mental health in a number of ways, including lowering blood pressure, improving sleep, and releasing endorphins – the feel-good neurochemicals that can reduce pain and make you feel happier!
 

Our sexuality and libido can be inhibited by our physical and mental stress loads.

When our bodies and minds are under considerable stress, the natural physiological response can include the down-regulation of our sex drive. As reproductive processes are quite expensive energetically, our bodies cleverly divert this energy towards more basic survival functions – regulation of heart rate, breathing, adrenal activity, etc. This is exactly what our bodies should do in emergency situations. Just imagine our ancestors spotting a predator stalking them on one side, and an attractive potential mate on the other. The instinct to respond to the predator should, ideally, win out over the instinct to procreate. Which is, let’s face it, where our biological urge for sex or sexual intimacy primarily comes from.

Unfortunately, with ongoing chronic stress, these responses become our baseline. It’s all hands on deck in the sympathetic nervous system, which helps us decide whether we fight or flee. It can be very challenging to break away from this response, which is deeply wired into our brains to keep us safe.

But it is possible to work towards a more balanced stress response, which will help your body and mind to be more receptive to sexual arousal.

Side effects and physical changes from cancer treatments can include affected hormones, changes in body image, and heightened or lowered sensations in the body (pain, numbness, etc).
 

It goes without saying that some the most confronting issues surrounding sexuality and cancer tend to be related to the aftermath of the treatments themselves.

A number of cancers are treated with hormonal therapies (most commonly anti-oestrogenic or anti-testosterone therapy). Since our sex drives are significantly driven by our hormones, these treatments can have a massive impact.

Chemotherapy and other pharmaceutical therapies can leave patients feeling nauseous, exhausted, and weak. A common complaint amongst women is a lowered ability to produce enough natural vaginal lubrication to make sex enjoyable or even comfortable. Surgical operations may leave one feeling out of touch with their body on a sexual level, particularly if surgery has been performed on the breasts or genital organs.
 

Understanding that your sexuality is not determined by your anatomy, your physical appearance, or even your ability to perform sexually as you once did, may help you to explore yourself in ways that didn’t occur to you before. It may be that this is an opportunity for you to redefine what it means to you, as an individual.

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Can acupuncture help people with cancer and sexuality?

If you’ve never experienced acupuncture (or even if you have!), you may be wondering how acupuncture comes into play when helping cancer patients with their sexuality. First, let’s discuss what acupuncture is. Modern acupuncture practice involves using sterile, single-use filiform needles to penetrate the skin in various locations. The points chosen for each treatment will vary depending on the patient’s needs that day, as determined by their practitioner. There are many schools of practice when it comes to acupuncture, and treatment styles depend on the practitioner’s training and individual clinical experience.

While I won’t go into how acupuncture works, there is a clear connection between acupuncture treatment and our wholistic functioning – to put it simply, the connection between our brains and our bodies. Because sexuality originates in the brain, implementing any practice that creates balance in the autonomic nervous system (our stress response centre) can support healthy sexuality and sexual function. There are many ways to manage our stress response, but as a completely biased ad passionate acupuncturist, I think acupuncture may be one of most captivating.

Acupuncture treatment considers the entire person mind, body, and spirit, when creating a clear picture of the patient. As I say, we don’t treat symptoms or diseases, we treat people.

This is why we end up having the types of conversations that get left out during most medical consultations. Oncologists and other specialists are very good in their area of focus, and acupuncture is good at tying it all together by regulating the systems that are running in the background - which include our physiological functions as well as minds, our emotions, and our sexuality.

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How can acupuncture support patients with cancer?

So how does system regulation help support cancer patients? Well, first let’s look at some of the ways that cancer diagnosis and treatment can affect people on a wholistic level – looking at the body and mind as a whole system. The more obvious troubles tend to be related to side effects of treatment, whether surgical, radiation, chemo, other pharmaceuticals, or combinations of these. This can include scarring, pain, loss of body parts or organs, neuropathy, nausea, and fatigue. Mental and emotional impacts often include depression and anxiety, grief, insomnia, and overwhelm.

When a cancer patient seeks treatment with an acupuncturist, there will often be a few key concerns that will be addressed, depending on what the patient needs on that day. But there will almost always be pattern-related points chosen to support the overall function and health of the person. In my practice, I find that honing in on the neuro-somatic (brain-body) connection during treatments helps to achieve a better balanced autonomic nervous system. When the autonomic nervous system in in balance, the “fight or flight” response is downregulated, and the “rest, digest, reproduce, and repair” functions of the body will be in better function. This can be demonstrated through decreased perceptions of pain and discomfort, better quality sleep, and an overall sense of ease. Regular treatments mean better chances of these results sticking around, whereas sporadic treatments may give temporary relief – but sometimes that’s all you need!
 

Some treatments can leave behind severe scarring in patients, especially where invasive surgical procedures have been used. In cases where healed scar tissue adhesions are causing discomfort, a more physical approach is taken, where the needles themselves are used to gently soften scar tissue. In addition to acupuncture, bodywork methods such as massage, cupping, or gua sha may also be implemented to soften scar tissue and break up underlying adhesions. These treatments will usually also involve supporting points to encourage the body’s healing process and free flow of blood and body fluids, nourishing the physical tissues.

How can an acupuncturist help with sexuality?

When your neuro-somatic pathways are functioning optimally, and you are not in a state of “fight or flight,” your body is better able to relax, conserve energy, create fresh new cells, and focus on personal expressions of creativity and sexuality. For us to tap into our sexual selves, especially for women, there must be a sense of safety. Expressing ourselves sexually, even in our own company, requires some level of vulnerability. If our minds are overburdened with the many stresses that can accompany cancer diagnosis and treatment, we will not be able to fully relax into our sexual self, or feel the pleasure we could be experiencing.

When my acupuncture patients report to me that they have been sleeping better, have felt more focused or more motivated, and are generally at ease, I know that their brains are in a better space to experience and develop their sexuality. The good news is that exploring sexuality also helps to regulate stress- response. It’s not a one-way street! Rather, it is a feedback loop. So alongside regular acupuncture treatment, I encourage patients to explore their sexual side through a variety of methods – whichever make the most sense to them at the time. This might be through reading articles about sexuality, journaling about it, self-massage or self-pleasure practices, and even through partnered or solo workshops designed specifically for personal sexuality development. Many women these days also opt to join online support groups where other women are discussing their sexual explorations in a safe space.

Breast cancer and sexuality

Breast cancer treatments, including surgical removal of breast tissue and radiation therapy, can leave behind a wake of physical changes that impact the way a woman feels about her body. These very abrupt changes to her body visually and in the way it feels to her, can be very difficult to come to terms with. Anxious and depressive feelings about these changes are quite common, as are feelings of insecurity with their sexual partner.

Poor or altered body image is something that many women struggle with even before cancer treatment, but the aftermath of some treatment protocols can leave women truly overwhelmed with grief for their bodies. They may fear that these changes will lead their partner to leave them adding to the fear they have already been dealing with.

Body image aside, there are more direct effects on sexual function as a result of cancer treatments. Low libido, vaginal dryness, pain during sex, and low energy are a few of the biggest complications that impede on sexuality and sexual enjoyment. This can be directly related to changes in hormones in oestrogen-inhibiting therapies as well as chemo and other pharmaceutical treatment. These hormonal changes have a number of different effects on both the psychological side of sexuality, but can also cause changes in vaginal tissues and function, similar to that in menopausal women. In fact, many women going through cancer treatment will experience ‘early menopause’ as a result of cancer treatment.

One common issue that that vaginal walls become thinner, less lubricated, and more likely to tear. Unaddressed, this could lead to ongoing vaginal discomfort, fear of sex, and a higher chance of vaginal infections.

Where acupuncture may not be able to reverse the effects of treatment entirely, treatment can be focused on helping to increase the flow of blood and yin fluids to the vaginal area. Topical products such as natural lubricants and oestrogen creams have also been reported to help with these issues. As discussed earlier, self-massage and self-pleasure can also help to increase blood and body fluid flow in the pelvic area, and may help to recover or partially recover sexual function if done regularly.
 

In a study done on women’s intimacy and sexuality after cancer treatment, 50% of women reported sexual difficulties following breast cancer treatment.

In a study done on women’s intimacy and sexuality after cancer treatment, 50% of women reported sexual difficulties following breast cancer treatment. This includes the issues and discomforts mentioned previously, as well as difficulty in reaching orgasm.  

Up to 45% also reported experiencing symptoms of anxiety and depression, which gives cause to wonder, how much mental health is contributing to these problems alongside physical side effects.
Interestingly, 75% of women reported that they felt they became closer with their partner as a result of breast cancer. As partner support seems to be a major factor in cancer treatment’s detriment to women’s sexuality, it begs a clear indication that we need to help partners learn how to offer appropriate support as well as communicate and listen effectively to their female partners with cancer. (2)
 

Ovarian cancer and sexuality

All of the complications that cancer treatments can have on sexual function, vaginal lubrication, etc. But for women whose fertility will be compromised, ovarian cancer brings another layer of psychological burden, particularly for those who are wanting to have children, or wanting more children. Women who want to have children but cannot due to oophorectomy (removal of the ovaries) may feel like the impact on their fertility translates to being less feminine, less maternal, and less desirable as a woman. Particularly if there is pressure from their partner to have a child, they may feel like their value to their partner has decreased.
 

We won’t get too much into fertility or options for family planning here, but it’s important to acknowledge that our families, our individual cultures, and many religions put a lot of pressure on women when it comes to childbearing. It’s important to communicate with your partner if this is something that is weighing on you, as they may not be aware of these social pressures you are carrying.

Again, this is where support groups of women who have gone through similar experiences are wonderful, as they will help to remind you that your femininity, your value as a woman, and your sexuality are not tied directly to your ability to reproduce. Psychological counselling with a mental health professional who specialises in women’s health would also be incredibly helpful here, as this topic is sometimes quite deeply intertwined with our identities as females.

Cervical cancer and sexuality

Cervical cancer treatment, much like that of other women’s cancers, may include treatment that causes hormone disruptions, vaginal dryness, low sex drive, and any of the various side effects of chemo or radiation therapy.

Depending on the stage of diagnosis, and whether the cancer is only locally within the cervix, surgery may be performed to remove the cancer. This may be minor surgery, removing a small portion of the cervix, and might not cause much disruption to sexual activity once healed from the surgery. But in some cases, surgeons may remove the entire cervix or even perform a total hysterectomy, including the cervix and he upper portion of the vagina. This can completely change the shape, size, integrity, and function of the vaginal canal.

For many women, reconnecting with their sexuality means discovering what works for them and what doesn’t, and being able to communicate this effectively with their partner. These women, too, might benefit from relevant support groups and counselling, particularly if they have undergone invasive surgery.

Complementary Therapy - Here’s what an acupuncturist wants you to know about cancer and sexuality

Let’s revisit what was said at the beginning of this article. You are in no way obligated to fit into any societal standards or expectations of sexuality. You are in the driver’s seat. And you are being invited to explore what sexuality means to you. For some, it will hold a traditional meaning – being able to perform and enjoy traditional sexual activities with a partner. Others might think of it as an internal power, having more to do with your own senses, confidence, and enjoyment. Some might think of it as intimacy and vulnerability with a partner, with or without sex itself. These and more interpretations of sexuality are all valid!

That being said, if you are unsure what it means to you and what your goals are, this is where you might consider starting. Take some time to explore its significance to you - not to society, not to your partner – only you. What do you want to gain from it? How do you want to feel?

Perhaps you don’t want to explore this at all, or you’re just not ready. That’s ok too! There is nothing wrong with choosing a non-sexual lifestyle, if you feel that this suits you.

But if you do feel like you want to reconnect with your sexuality, your intimacy, and your inner sexual self, here are a few suggestions to get you started:

• Journaling. Write down your own thoughts and inner conversations about this topic. What worked for you in the past? What do you think will work for you now? What do you feel are your biggest obstacles to feeling sexual? What are your triggers that may make you not feel sexual? What do you think you or your partner can do to make you feel more desired? Do you feel safe to express yourself sexually, and why or why not?
• Yoga, dance, and other gentle movement classes. Being reminded of what your body is capable of, and feeling it grow more flexible and stronger, is a wonderful way to reconnect with your confidence, your body, and your sense of Self.
• Keep your expectations reasonable and be kind and respectful to your body. It won’t take long at all before you fall in love with it again.
• Get regular acupuncture treatment. Support your brain and body’s ability to tap into your sexuality and downregulate any feelings of overwhelm and discomfort that are inhibiting you.
• Seek counselling with a mental health professional whose focus is in women’s cancer or women’s health concerns.
• Talk about it with a healthcare professional. Remember what we were saying about sexual health not being a common enough conversation amongst healthcare professionals? Well, the conversation has to start somewhere. If nothing else, they can refer you to someone more versed in sexual health, who can help to guide you on this beautiful, delicious, fulfilling journey that is your life.
   

Concluding thoughts

Your individual journey navigating cancer diagnosis, treatment, and beyond is going to be unique to you, and so will your needs with it comes to your sexuality and sexual experience. You don’t need to have all the answers before you begin. All you need is a desire to reconnect with your body, with your inner sexual self, and with yourself as a beautiful and self-compassionate human being.

While venturing into this side of yourself may not feel appropriate during some stages of treatment, it is always something  you can revisit as desired and as you feel ready.

I recommend to start simply – find support, show yourself patience and grace, and be open to loving yourself and your body in every way. Your inner sexual being never left, it just needs to be shown the nourishing care that we all want and deserve.