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Awkward Auntie Question No. 17

woman in bed

Ever had a question about relationships or sex that you just can’t ask your oncology care provider?  Ever felt too shy to ask a nurse or doctor a question but really needed the answer?  Now you can ask those questions and get answers from Dr. Anne Katz, the Awkward Auntie!

Question:  I have been struggling with intimacy since starting cancer treatment. I have no sex drive and whenever I try penetration with anything it burns. I’ve tried lube which hasn’t helped much, and anything that is inserted is just painful. Any tips on what to do about this or how to talk to my oncologist?

Awkward Auntie:  The answer to this is in two parts:

1. How to talk to your oncologist – Straight talk is needed here. “I feel like this and like that and I would like to see someone to help me with this. Can you refer me to a sexuality counselor or GYN who knows about cancer and its treatment” is a good place to start. Remember that oncologists are not trained to deal with the sexual side effects of treatment. Your treatments have stopped your body from producing estrogen and this is why you have pain with attempted penetration.

2. Lube – Have you tried a SILICONE based lubricant? These are the best lubes out there and anything else is not going to be slippery enough. This kind of lube does not have any additives and that might be what is causing the burning. Astroglide Diamond is a good one to try.

You should also see a pelvic floor physiotherapist because in response to the pain you may have pelvic floor involvement (a defensive reaction to the pain) and this causes more pain with any additional attempts.

Another thing to think about is that sexual desire does NOT need to come before you get something started – it is not a requirement for a satisfying sexual experience. Let me explain – many women (for all sorts of reasons) do not have spontaneous desire but rather start to feel desire once they are turned on by physical or verbal stimuli. So once you and your partner get things going, that is often when a woman feels reactive desire or interest. But you need to get the pain issue under control of course.

You can learn more about this great program, find the answers to past questions, and submit a question of your own by going here!

More about the Awkward Auntie program:

Dr. Anne Katz, also known as the Awkward Auntie, is a certified sexuality counselor and nurse who has written a couple of books about young adults and cancer – and all the things that happen to your body, relationships, and sex during and after treatment.  She will be answering any and all questions that you send to or that you submit in the form below. You don’t have to give your name or other identifying information – but it might be helpful for her to know how you identify yourself by gender, your age and what kind of cancer and treatment you had.

YOU CAN ASK HER ANYTHING…. Don’t hold back!  Your questions will be answered periodically and posted on our Awkward Auntie page.