Cancer Survivor: Can I Have an Intimate Relationship Again?

A reader wrote:

 I am 62, single, and once was a very sexually active woman. I've undergone treatment for breast cancer twice. My recovery required my full attention for years, but now I feel ready for new adventures -- hopefully including sex. After rounds of chemotherapy, surgeries, radiation, and continued estrogen blocking medications, sex with another became a thing of the past. 

Currently, sexual intercourse may no longer be possible for me -- but I still enjoy having orgasms and I desire the wonder of touch. However, I am so concerned about my limitations as a sexual partner that I am afraid to attempt to date again. 

I have no idea what men in my age group expect or desire in terms of performance from their partners. What are woman experiencing in the 60-year-old dating world in terms of performance expectations? Would my current physical circumstance deter most men from being interested in exploring an intimate relationship with me?

I am grateful for this message and all it conveys about hope and healing and moving forward. I understand why you're apprehensive. I would encourage you to get out there and go after what you want.

I know that many single men in our age group also fear "performance expectations"  when erections are no longer possible or predictable. There are many who would welcome a sexual partner who did not expect intercourse, who would be happy exchanging touch, oral and manual stimulation, and fabulous orgasms -- without intercourse.

These men may be cancer survivors themselves, wanting to return fully to life, including sex and intimacy, but they don't know how to navigate the dating world either -- when to divulge the cancer, when to divulge the sexual issues.

You might find out if there's a local cancer survivors' singles group. Or try online dating: I did a search on "cancer survivors singles" and came up with several sites that promote themselves as dating sites for cancer survivors.

There's even one -- "2date4love" --  that "enables people who cannot engage in sexual intercourse to meet and experience love, companionship and intimacy." I haven't vetted any of these sites -- if any of you have tried them, I hope you'll share your experiences.

You don't need to limit yourself to dating companions who share a similar medical history, though. Just be up front about your cancer on a first date if it looks like there's potential for a second date. (If not, you don't need to mention it.)

Then if you progress to a few dates and there's chemistry, it's important to explain that yes, you are interested in sex, but no, this might not include intercourse. Be prepared: Men who desire intercourse may want to discontinue getting to know you, and that's okay.

When all the cards are on the table, if the relationship progresses, you have the delightful journey of exploring all the ways you can be sexual without intercourse!

Even when a date doesn't progress to more, it's still worth getting to know new people, "practicing" dating, trying out how to tell a potential partner about your needs, desires, and challenges.

If you take it all as part of the brave new world of dating experience, you don't need to feel regretful or shamed when a new relationship (or potential relationship) doesn't work out. Most of them will not work out -- that's the nature of the game.

Everything I've said so far presumed that you're right that intercourse will not be possible for you. But please explore whether there are ways that you can heal yourself vaginally, if this is something you want to pursue. An excellent resource is "Vaginal Recuperation after Cancer or Surgery" from A Woman's Touch, one of my favorite sexuality resource centers.


I hope you'll check in again and share what you tried, how it worked for you, what you learned and gained.

I hope that you'll share your thoughts, too, readers.

Adult Sex Ed Month: HuffingtonPostLive, AASECT conference, and a new senior sex book

 June has been declared Adult Sex Ed Month (#AdultSexEdMonth) by Ms. Quote (@GoodDirtyWoman on Twitter) who blogs at A Good Woman's Dirty Mind. This idea caught on, and this month, hundreds of posts designated #AdultSexEdMonth from sex educators and bloggers appeared all over the Internet. View the list with links here.

In my world -- advocating for senior sex and educating about older-age sexuality -- every month is Adult Sex Ed Month. This month has been particularly fruitful.

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This month, I participated in a Huffington Post Live event titled "How Old Is Too Old To Have Sex?" with fellow panelists Ashton Applewhite, Walker Thornton, Sidney Schwab, and Ken Solin, hosted by Abby Huntsman. Of course the answer to the question in the title is obvious to us (though not obvious to Abby, until we raised her consciousness), but you'll find the discussion interesting even though you know the answer! Watch it here:

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The annual conference of the American Association of Sexuality Educators, Counselors and Therapists conference always makes my brain swell with new information and ideas from sex educators who are trailblazers in the field. Counselors, therapists, sex educators in community or medical settings, and other people who care about your sexual knowledge and enrichment gather to learn from the leaders. Then people like me come home and spread it around – to people like you.

As always, it was impossible to attend all the sessions of interest, and there’s no way I can share all of the 25 pages of single-spaced notes that I took on my laptop, no matter how many blog posts I write. But here are some highlights and tips that are especially relevant to our age group:

• Some sexual issues are psychological; some are medical or physiological. But even when it's a medical issue, a sex therapist can be important to help you work with whatever is going on. Medical sexual issues affect your sense of self and your relationship. “Any pharmacotherapy for sexual dysfunction should occur within the context of sex and relationship therapy.” (Ricky Siegel)
• One more good reason to quit smoking: Nicotine has been shown to decrease blood flow to the penis and increase venous outflow from the penis -- in other words, less ability to get and maintain an erection. (Ricky and Larry Siegel)
• Women with vulvar or vaginal pain have a difficult time getting the pain diagnosed and treated effectively. Possible causes of pelvic pain are varied, and with the wrong diagnosis (or no diagnosis!), the wrong treatment follows. Look for a three-pronged approach: a sexual medicine physician, a pelvic floor physical therapist, and a certified sex therapist, such as used by the Summa Center for Sexual Health in Akron, Ohio. (Kimberly Resnick Anderson)
• Pelvic floor physical therapists are trained to do internal evaluation of the pelvic floor muscles -- evaluating muscle function, strength, tone, and any points of tenderness. Regular physical therapists are not trained to do this. (Amy Senn)
• Men with low libido: Anxiety, mood, relationship, and religious factors affects libido. “First know what’s going on in the relationship before throwing medication at it.” (Larry Siegel)
• "Nerve sparing" prostate surgery is "a bit of a misnomer." Erectile nerves on the outside of the prostate are very difficult to see and avoid during surgery. "The prostate is deep in the pelvis, and they go pushing around with stainless steel instruments. If cauterizing instruments are anywhere near nerves, it damages them for life. Nerves recover from the pushing and pulling – it takes a long, long time. Nerves go into shock and stop sending message to blood vessels to relax and let blood in.” (Anne Katz)
• “Sexual arousal requires healthy blood flow for everything else to work. Otherwise, nothing happens. Take a 15 minute walk with your partner before sex. It will prime the pump.” (Ellen Barnard)
• After treatment for female genital cancer, using a vibrating wand internally will reduce scar tissue. "Vibration directly to the scar tissue starts breaking up that scar tissue, allowing it to expand, become more comfortable, and allow penetrative sex if we want it.” (Ellen Barnard)
• After cancer treatment, start getting to know “what is”: “What feels good? What doesn’t feel good? What’s numb? What’s painful? How does arousal happen? What does it take? How does orgasm happen and feel? When during the day do I have energy?” (Ellen Barnard) You need to learn this for yourself before you can teach your partner.  (JP: This applies to aging in general, also.) A Woman's Touch has excellent educational brochures for both men and women online at no cost, for example, Healthy Sexuality After Cancer. Visit  www.sexualityresources.com, see the Educational Brochures link in the upper left hand corner of the menu bar for a complete selection.

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The huge news this month for me as a senior sex educator was an invitation from Cleis Press to write a book for them: The Ultimate Guide to Sex after Fifty! I'm thrilled to have a new book to write on my favorite topic, and I'm proud to be part of the fabulous Ultimate Guide collection of sexuality guidebooks. You can be sure you'll hear more about my new endeavor as it unfolds.

Meanwhile, if there's a topic you want to be sure that I cover in this new book, please either post it as a comment here or email me. I love to hear from you. I'm too busy to promise to answer all your questions in detail, but I try to acknowledge your email and point you in the right direction. I admit sheepishly that I have about 400 unanswered emails waiting. If one of these is yours, I thank you for your patience!  (I do give private, educational consultations answering your questions by phone or Skype for a modest fee -- email me for more info about this.)