Posted 3 years ago

Restoring Female Sexual Health After Cancer

After a cancer diagnosis, many women are concerned about how cancer treatments will affect their sex life.   In fact, a recent study estimated that 87% of women with cancer have concerns about how cancer will impact their sexual health.  Unfortunately, many times, conversations about sex and intimacy are not addressed in their visits with their cancer care team.

A cancer diagnosis can cause tremendous amounts of stress and chaos in one’s life with the busy schedule of appointment for tests, treatments and surgeries. With all this busyness, many times, sexual related concerns are put on the back burner.  Some common problems faced by the cancer survivor are physical changes, like loss of breasts, changes in vaginal health including dryness, decreased sensation and pain with sex and emotional challenges including body image and sexual desire.  Additionally, cancer can impact the dynamics of a relationship and have a negative impact on intimacy.

One of the myths around sex after cancer is that these problems will resolve on their own , when in fact, many of these issues if not addressed, will not resolve with time and can be associated with a lower quality of life and higher rates of depression in cancer survivors.  Fortunately, even with all the challenges that cancer treatment can create in one’s sex life, most women report that with treatment, they are able to return to a satisfying sex life.

Pain with Sex

Pain with sex is one of the most common complaints that cancer survivors report.  Hormonal changes from cancer treatments  and the impact of radiation or surgery to the pelvic organs can cause the vaginal tissues to be thinner and more fragile, narrow the vaginal canal and decrease the natural production of lubrication.   The most effective way to address pain with sex is to work  on increasing hydration to tissues by using a vaginal moisturizer every day and making sure to use liberal amounts of vaginal lubricants during sexual activity.  For many patients, the use of vaginal hormone creams may also provide some additional benefit to restoring vaginal health.  If a patient is experiencing significant narrowing of the vaginal canal, the use of vaginal dilators can be helpful to start to stretch the tissues to make intercourse more comfortable.  By working with a gynecologist  and,  if needed , a physical therapist that specializes in the pelvic floor , most women are able to enjoy sex again.

Body Image

Cancer treatments can cause physical changes that impact a woman’s sense of confidence and sexuality.  It is important for a woman to acknowledge that these are valid, not trivial concerns, that she is experiencing and that they are very common feelings in cancer survivors.  It is also important to understand that grief can be part of the processing a woman will go through to   come to terms with the physical changes brought on by her cancer treatment.  To work on coming to accept these changes, self-compassion and positive affirmations can be  helpful tools to develop a positive body image.   Therapists can also be very helpful members of the cancer team to help women with restoring a healthy body image.

Decrease in Desire

Decrease in sexual desire, or low libido, is another common problem experience by cancer survivors.  Sexual desire is a complex issue that many times is oversimplified to being related to hormone levels when in fact hormones including testosterone, estrogen and progesterone are thought to have only a small influence on a woman’s libido.  In cancer survivors, more commonly, issues of pain, body image, fatigue, depression, medications affects or a changed/strained relationship with one’s intimate partner are  found to have the biggest impact on libido.  In order to improve sexual desire, the most effective approach is to identify and treat the underlying issues that are impacting libido.

Restoring sexual health after cancer is an important part of improving quality of life in cancer survivors.  Many of the issues that are impacting a healthy sex life can be significantly improved if addressed appropriately.   Although this conversation may be uncomfortable for some patients, it is important for cancer survivors to start having these discussions with their cancer care team to get the help that they need.

Dr. Heidi Rula Integrative Oncologist Ironwood Cancer & Research CentersAbout Heidi Rula, M.D.

Medical Director of the Supportive Care Services Department

Dr. Heidi Rula Joined Ironwood In 2018 To Launch The  Integrative Oncology Program. She Is Board Certified In Family Medicine And Fellowship-Trained In Integrative Medicine. Dr. Rula Has Been A Practicing Physician In The Phoenix Area For Approximately 20 Years And Has Been Recognized By Her Colleagues As One Of Phoenix’s “Top Doctors” On Multiple Occasions.

Dr. Rula has played a key role in bringing integrative medicine to the Valley. She served as the medical director of the University of Arizona Integrative Health Center, where she leads a team of physicians and complementary practitioners in a unique model of integrative primary care that she helped to develop along with Dr. Weil and the UA Center for Integrative Medicine.

Provider Profile & CV

About Ironwood Cancer & Research Centers

Ironwood Cancer & Research Centers (ICRC) is the largest multi-specialty oncology network in the Greater Metro Phoenix area. They have over 100 medical providers, a robust Integrative Services program, and a dedicated clinical research department. Ironwood Cancer & Research Centers has 15 valley locations and five comprehensive cancer care centers that offer a multi-disciplinary approach for expedited personalized patient care. For more information, please visit