Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian households. As a result, most individuals dealing with sexual health issues or trying to find information about sex often resort to unverified online sources or follow the unscientific advice of their friends.
To address the widespread misinformation about sex, News18.com is running this weekly sex column, titled ‘Let’s Talk Sex’. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.
The column is written by sexologist Prof (Dr) Saransh Jain. In this article, Dr Jain will explain how Lymphoma treatment can affect your sexual health and how to cope with it.
Lymphoma is a cancer of the lymphatic system. It develops in lymphocytes which are a type of white blood cell. These cells help fight disease in the body and play an essential role in the body’s immune defences. As this type of cancer is present in the lymph system, it can quickly metastasize, or spread, to different tissues and organs throughout the body. Lymphoma most often spreads to the liver, bone marrow, or lungs.
When you receive a diagnosis of lymphoma, conversations about sexuality and intimacy are often not made a priority. However, you may be concerned about how lymphoma cancer and its treatment will affect your current or future relationships and your sexuality.
Sexuality refers to physical, psychological, social, emotional and spiritual factors. It includes self-image, body image, reproductive ability, emotional intimacy, sensual feelings and sexual functioning. Your sexuality is an essential part of who you are, how you express yourself and how you feel about yourself.
How Does Lymphatic Cancer Affect Sexuality?
Lymphoma treatment can impact your ability to have or enjoy sex. Chemotherapy or radiation treatment near the testicles may have lowered your testosterone levels and/or damaged blood flow to the penis, resulting in various sexual concerns such as the inability to keep a firm erection (also known as erectile dysfunction), pain during sex, difficulty reaching or dry orgasm and loss of desire for sex.
Treatment (particularly radiation or intrathecal chemotherapy) near the brain stem can also damage the pituitary gland and lower testosterone levels. You may also be taking various supportive care medications such as medication for pain that have left you with a lack of desire to engage in sexual activity. In addition, other factors can impact your sexual health. These include your age, your weight, your blood pressure, your drinking or smoking habits, as well as various psychosocial issues.
Sexual Issues with Lymphatic Cancer
Sexuality-related issues may arise from the physical aspects of your disease or treatment, as well as from emotional aspects. Anger, guilt or worry about illness and survival, treatment or finances may also affect sexuality. Some physical or emotional effects resolve over time or when treatment ends while some effects may be long lasting.
These are some issues that you may encounter and suggestions to help alleviate them:
Erectile dysfunction: This is usually caused by low testosterone levels or damage to blood vessels in the penis. Consult a doctor who has special training in treating men’s sexual problems. They may recommend medicated treatments, vacuum devices, penile injections, penile suppositories, penile prostheses, or other alternative treatments.
Lack of pleasure and orgasm: Cancer treatment is rarely the direct cause of decreased pleasure or ability to reach orgasm. This may be caused by medications such as antidepressants. This can also be due to emotions associated with erectile dysfunction or infertility. Ask your doctor or even a counsellor to help you through these issues
Lack of desire, negative thoughts and feelings: Try to identify the cause of these emotions. For example, it may be caused by other feelings such as worry, pain, or fatigue. It may also be related to having difficulty with erections or it may be a side effect to pain medications. If it is the latter, ask your doctor to suggest alternative support medications
Other Sexual Issues: Other factors that may impact sexual desire and function includes Dyspareunia (low oestrogen levels), Vaginal dryness and also there is a possibility of re-emergence of previous STI’s due to immune deficiency (eg. genital warts, herpes).
Psychological Factors: There are various psychological factors that can impact on sexual function such as:
- High levels of anxiety, stress, worry or fear
- Role changes (husband and wife vs patient and carer)
- Loss of feeling relaxed and safe
- Altered body image/poor body image (eg. hair loss, weight loss, weight gain)
- Low sexual self- image
- Previous negative sexual experiences
Adapting to a New ‘Sexual’ Normal
Often, the negative impacts on sexuality and intimacy from lymphatic cancer treatment subside after treatment finishes. However, sometimes the impacts can be longer lasting or even permanently change your desire for sex and your ability to have sex or be intimate. For many people, adjusting to these changes can be difficult and may even cause friction in your relationships over time. If this is you, below are some strategies and interventions you may want to consider implementing:
- Consider pain relief and positioning
- Create a relaxing environment for sex and intimacy
- Focus on pleasure not performance
- Allow yourself to grieve the loss of familiar sexuality and sexual response
- Practice talking openly about sex and your feelings with your partner
- Explore new satisfying sexual activity after treatment
- Investigate use of sex toys – vibrators, dildos, lubricants
Many people find it difficult to discuss their sexual concerns with others; however, your doctor, or a specialist in sexual health, can help you overcome these issues. These healthcare professionals can recommend counselling, medication or surgery to help you.
Communication with your partner or a potential partner is also important. A vital part of your quality of life after your lymphoma experience is sexuality. Break the pattern that sex must lead to penetration and orgasm. Keep in mind that it is possible for both men and women to feel sexually satisfied and bonded with a non-orgasmic experience. Consult with your doctor to rule out any physiological problems. A sex therapist can assist in solving certain difficulties.
Prof (Dr) Saransh Jain is the winner of the Swasth Bharat Rattan Award and is a Certified and Licensed Sexologist by the American Board of Sexology. He is currently a Senior Consultant at Dr SK Jain’s Burlington Clinic in Lucknow. The views expressed in this article are those of the author and do not represent the stand of this publication.
