Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

After cancer treatment, sexual health challenges are often shielded from partners

Anne Katz, RN, PhD
Conditions
July 20, 2016
Share
Tweet
Share

asco-logo

The phone rang in my office one morning last week.

Woman: “I received a notice of an appointment with you, and it says to bring my partner or spouse with me. This problem has nothing to do with him.”

(The opening statement could just as easily be from a man, and often is.)

I quickly looked up her notes in the electronic medical record and saw that she is a breast cancer survivor who, at her last appointment, reported vaginal dryness and loss of libido secondary to endocrine treatment.

I explained that I prefer to see couples, as solutions to these sorts of problems are usually only resolved when both members of the couple are seen.

“But he doesn’t even know that this is a problem …” was her reply.

This is also not an unusual response. I once saw a couple for counseling and the woman, a breast cancer survivor on adjuvant aromatase inhibitor therapy, said that she was comforted by the fact that her husband did not know how much sex hurt because her tears flowed backwards into the pillow. A quick glance at her husband’s face told me that he knew how much it hurt and how awful he felt that something that should be an expression of love caused her pain. It is not unusual for the male partner to develop his own sexual problems as a result of this; rapid ejaculation (“let’s just get this over quickly”) and erectile difficulties (“I feel guilty about hurting her”) are not uncommon in these couples.

I explained to the woman on the phone that unless her sexual activity was restricted to solo endeavors, her partner needs to be part of any potential solution. I didn’t say it at the time, but I am pretty sure that he is aware that the vaginal dryness, in particular, is a problem. She can perhaps hide her loss of libido, and many women do, but any sexual activity that they have had must have suggested to him that she was in discomfort or frank pain. Most survivors try to muddle through the sexual changes after treatment and it often takes a long time for them to ask for help. And she asked for help and was referred to me.

I often see men who have erectile difficulties after surgery for prostate or colorectal cancer. Their partners are very well aware of the problem, but the men think that this is their problem to solve. They are often willing to go to great lengths to have erections, and some even try to hide erectile aids from their partner. This usually results in failure; if they don’t talk to their partner about their interest in sexual activity, they take a pill and then find that they have wasted their money because their partner goes out or starts watching a movie on TV. I have even had one or two patients who have tried to hide the needles and vial of medication for intracavernosal injections.

The subterfuge and taking on the “problem” to be “fixed” reflects essentially on our difficulties in communicating about sexuality with the person we are sexual with. And if we can’t talk to that person, how can they know what feels good, what doesn’t, what one likes or prefers, and what we would rather avoid? Yes, we have facial expressions, and we can swat a hand away, grunt or moan, but wouldn’t it be more efficient to use our words? That is where counseling plays a vital role in solving problems and finding solutions. In counseling, our patients have to talk, and from that talk comes understanding and sharing and empathy and, eventually, solutions and resolution.

I really hope that the woman on the phone at the very least tells her husband about the appointment with me. And perhaps he will come with her. Without the two of them participating, nothing will change, and their sexual relationship will continue in pain or will cease. The choice is hers to make.

Anne Katz is a certified sexual counselor and a clinical nurse specialist at a large, regional cancer center in Canada who blogs at ASCO Connection, where this post originally appeared. She can be reached at her self-titled site, Dr. Anne Katz.

Image credit: Shutterstock.com

ADVERTISEMENT

Prev

I have seen both worlds, and the naturopathic one is terrifying

July 20, 2016 Kevin 46
…
Next

The demise of FluMist is a victory for science

July 21, 2016 Kevin 5
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
I have seen both worlds, and the naturopathic one is terrifying
Next Post >
The demise of FluMist is a victory for science

ADVERTISEMENT

More by Anne Katz, RN, PhD

  • Breast cancer’s silver lining

    Anne Katz, RN, PhD
  • Genital shrinkage is real. And so is the distress it causes.

    Anne Katz, RN, PhD
  • Do COVID restrictions in the office negatively affect patients?

    Anne Katz, RN, PhD

Related Posts

  • Obstruction of medical justice: How health care fails patients with cancer

    Miriam A. Knoll, MD
  • How to avoid treatment you don’t need

    Marshall Allen
  • The health effects of structural racism

    Niran S. Al-Agba, MD
  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • 4 disturbing trends in health care

    Praveen Suthrum
  • How social media can help or hurt your health care career

    Health eCareers

More in Conditions

  • Clinical ghosts and why they haunt our exam rooms

    Kara Wada, MD
  • High blood pressure’s hidden impact on kidney health in older adults

    Edmond Kubi Appiah, MPH
  • How declining MMR vaccination rates put future generations at risk

    Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
  • How one unforgettable ER patient taught a nurse about resilience

    Kristen Cline, BSN, RN
  • Why regular exercise is the best prescription for lifelong health

    George F. Smith, MD
  • When the weight won’t budge: the hidden physiology of grief, stress, and set point

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • How shared language saved a patient from isolation

      Syed Ahmad Moosa, MD | Physician
    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...