Although it might take some effort, it is possible to continue enjoying your sex life during and after cancer treatment. There’s this old joke about a man who breaks his fingers and, after he has them straightened and put in splints, asks ‘Doc, will I be able to play the violin?’ To which the doctor replies, ‘Yes, of course you will!’ The patient then says, ‘Wow that’s incredible, I never played before!’ The answer to ‘Will I have a great sex life after my cancer treatment?’ depends largely on how things were before. Major problems in a relationship are not suddenly going to resolve because there is a crisis. They may be put on the backburner for a while, priorities may be reassessed, but they aren’t just going to disappear. That’s where specialized counselling can help.
If a relationship is stable and supportive and there is good communication between partners, they stand a very good chance of things getting back to normal. And of course there are those who never cared much for the violin anyway.
Your sexual routine may need to change, at least for a while, and the key to this is communication. Initially, that means communicating with health advisers so that you know what disruptions to your sexuality there are likely to be, so that you can plan ways of dealing with them. All the while, it is important for partners to communicate with each other. Sometimes that communication has to be more detailed than ever before.
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That being said, there is a point when unsatisfied sex drive in both men and women can interfere with the day-to-day running of your life; where thoughts and activities are so acutely directed at satisfying that drive that they push all other priorities out of the way. We call that ‘hypersexuality’. If that is the case, and the individual perceives it as a problem, then a sex therapist can often help sort it out.
At the other end of the scale is lack of desire. This can mean that you just don’t spare any thought for sex — you really can’t be bothered. By comparison, it doesn’t seem to cause as much trouble for the individual unless they are in a relationship where their partner is dissatisfied. Lack of desire has many causes and it can be an occasional thing, a short term phenomenon related to work or family worries, tiredness, illness or maybe being angry with your partner about some day-to-day nonsexual issue like forgetting your birthday or pranging the new car. Fran has three young children. ‘I know that if I have something on my mind like no money in the bank to meet the mortgage payments that month and Ron won’t sit down and talk to me about it, I get really tense and then I find it really difficult to show any interest in sex at all. Once we work out the “living together” issues, I let down the emotional barriers and the sex seems to sort itself out too.’
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Pregnancy can turn a man on or off. Jim told me, ‘During our first pregnancy I just couldn’t cope with the idea of having intercourse. It wasn’t that I found Tanya unattractive, it was just that the first few times we tried it after we found out she was pregnant, I kept imagining this little person inside being bumped around like a punching bag, and I was afraid of hurting it. I felt like I was intruding.’ Tanya worried about Jim’s lack of interest. ‘It was impossible to convince him that he wasn’t actually hurting the baby. I think he knew but he couldn’t overcome it, so sex was virtually non-existent with the first pregnancy. I wouldn’t have minded so much except he stopped any sort of intimacy, so at times I felt quite neglected. Now I’m pregnant again and he hasn’t lost his sex drive at all this time but because we have a toddler who won’t sleep through the night, that’s getting in the way now.’
Although it is a really common concern for both men and women, in the vast majority of cases sex does absolutely no harm to the mother or the unborn baby. However, there will be some cases when a doctor might have to caution against intercourse during pregnancy for medical reasons. If this is the case it can be very difficult for both partners unless the reasons are explained in detail, and they have a chance to ask any questions they may have. It may help to explore other ways of making love without vaginal penetration. Again, adaptability is the buzz-word.
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In a relationship with an agreed basis of fidelity, finding out your partner has had or is having an affair is usually its biggest challenge. It strikes at the heart of your self-confidence and trust and it can shake the foundations of the strongest relationship. Very few people can cope easily with the thought of the person they love having sex with somebody else. Above all it makes you question your own sexual adequacy, leaving you to ask, ‘Why wasn’t I enough?’
It has been estimated that there is an infidelity at some stage in around seventy percent of marriages. That makes the affair a common social covenant but one which is largely denied, and for good reason. There is a very real risk that it will tear the marriage apart. You see it all the time. But the question must be put: is society hanging onto a fragile facade of fidelity? It is more constructive to acknowledge the situation and look at it in terms of primary and secondary relationships, rather than using the term ‘affair’ at all.
Concealing a secondary relationship can be seen as a survival tactic for the primary (or what you perceive to be the most important) relationship. It is not so much a case of deception but a realistic fear of loss — of the primary partner withdrawing their love or just walking out. That’s why Rule Number One has always been … ‘Don’t get caught.’ So Rule Number Two is ‘Don’t catch anything.’ The reality is that any extracurricular (or secondary) sexual contact will increase your risk of transmitting a sexually transmitted disease to your primary partner. Without meticulous attention to safer sex practices, the risk is multiplied. Even without the health implications for your primary partner, a sure-fire way to ‘get caught’ is to ‘catch something’ and pass it on.
The reasons people have affairs are wide-ranging. Sexual boredom may be one of those reasons and some people will see an affair as the solution to discover new sexual and relationship skills. An extension of this is when one partner is not interested in sex, the other has a stronger libido and they are unable to reach a compromise. The partner with the stronger libido might not want to forfeit the primary relationship but still needs the sex. Many people also feel emotionally deprived or unsatisfied in a single longterm relationship. Some marriages are undoubtedly eroded by a secondary relationship. The painful truth is that many marriages are surviving and growing because of a secondary relationship rather than in spite of it.
If you marry young and stay with that partner you may reach a time when the curiosity to find out what sex is like with someone else becomes an irresistible temptation. The catalyst for this is usually a specific attraction to another person, rather than a deliberate effort to ‘just do it with someone else’.
If one partner is bisexual they may live in a primary relationship with someone of the same or opposite sex but, because of the dual nature of their sexuality, they may have a series of casual encounters or another relationship to satisfy this duality.
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The tragedy of AIDS flung the discussion of sexually transmitted diseases out into the light and right onto the front pages of the world’s newspapers and magazines. People were talking about sexuality and sexual practices in an unprecedented way. Frank conversations about the relative safety of oral sex or anal intercourse were becoming quite socially acceptable. Gone were the days when ‘safe sex’ meant making sure you didn’t get sprung by your parents. The world wondered whether it was facing the prospect of another Black Plague and that was the catalyst to dispense with a whole swag of social taboos. Along with this social revolution came a new honesty and directness in our approach to sex education. ‘Don’t do it until you’re married’ became a pathetic platitude irrelevant to the growing population of realists. It became clear that if people of all ages were to be able to protect themselves from AIDS (or any other sexually transmissible disease for that matter) then they had to have specific, detailed and unambiguous information uncluttered by moral judgments. More than that, they needed to be shown how to turn that information into action in the heat of the moment.
There is nothing quite like finding out you have a sexually transmitted disease to force you to take a look at your sexual attitudes and behaviors. Firstly, to figure out how you got it but more importantly so that you can prevent it happening again.
Knowledge means protection. I was lecturing recently to a group of health education students about the importance of educators being comfortable with their own sexuality and well informed about all aspects of sexual health so that they could cope with the questions and situations that were likely to arise in their classrooms. As an example, I asked them if they knew whether you could catch gonorrhea from oral sex. They were genuinely surprised that most of them didn’t know the answer. Now, some important points arose out of this exchange; one was that no matter how much you think you know about sex, there is always more to learn. More importantly, unless people have detailed information about the potential risks of the variety of sexual activities they might encounter, then they cannot hope to protect themselves. By the way, in case you were wondering, you can get a gonorrhea infection in the throat from oral sex with an infected person.
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