Not all women experience all the phases or all of the sensations in any of the phases. In addition, chemotherapy, surgery, and radiation can each change the way a woman’s body responds. For example, many women who have gone through chemotherapy get upset when they realize they have little or no sense of sexual desire. This is sometimes a temporary condition, but it may be long lasting.
Because desire can come before arousal or arousal can come before desire, if a woman does not have any desire, she might still be able to respond to her partner initiating love-making. Since research shows that female desire is driven by emotional attachment, her partner’s advances could “turn her on” sexually.
Desire is partly emotional and partly physical. Feeling desired is a strong component of the emotion. Thirty or forty years ago, researchers and others such as sexuality therapists believed that a woman’s sexuality was independent of what went on outside of her. However, subsequent research shows that a woman is strongly responsive to her partner’s feelings for her. Even if she already feels desire, her level of arousal increases if she feels wanted by her partner.
People undergoing treatment for cancer have experienced the change Dr. Basson presented in her research. Many people, both men and women, who go through various therapies become aware that they have little or no sexual desire. However, after the partner begins caressing, kissing, and touching, they can become aroused. The keys to arousal and then the desire to continue the sexual activity are receptivity to the partner’s actions, sensitivity, and emotional responsiveness.
Not a “Non-Stop Trip” to Intercourse
Some women may be concerned that beginning a sexual event means that they must go on to sexual intercourse. Often, women have a greater desire for hugging, stroking, and kissing, as those give them comfort and the feeling of being appreciated and wanted. Intercourse may not even be possible or wanted. This concern can lead to being reluctant to get started, even though they may want part of the sexual activity.
Actually, a woman has several choices as to how far she wants to go after becoming a partner in a sexual encounter. Although many people think about sex being the same as intercourse, sex can be seen as the overall term for physical intimacy, whereas intercourse is one of several possible end points.
Assume that a woman’s starting point of sexual arousal is zero on a scale of zero to five. After some foreplay, she may get to a two or three. Now she has an emotional connection with what is happening at the moment and with her partner. She also feels desire. At this point, the woman has three choices. She needs to remember that she has a choice and is not on a non-stop trip to intercourse. Other options include having a sensual interaction or manually bringing each one or even just one of the partners to a climax.
Keeping a sexual event at a sensual level involves a lot of touching, kissing, and hugging. Touching, caressing, and stroking are cornerstones of sensuality. There are also massage techniques such as sensate massage if either partner wants it.
Manual stimulation can be satisfying to both partners, as this allows them orgasms without intercourse. Partners may stimulate each other, or masturbate with the support of the other partner. They do not have to climax, but this outcome is available to them.
A woman has a choice anywhere along the way to decide how far she wants to go depending on how she feels at the moment. The challenge for a woman is to feel free to exercise her right of choice without feeling guilty or believing that her partner will be upset. Being comfortable with what she wants is based on good communication with her partner. A woman can stop at caressing or manual stimulation for herself, and still bring her partner to orgasm in many different ways - manually, orally, or with a vibrator.
Lifestyle Choices and Sexual Function
Lifestyle choices can harm sexuality. These include smoking, drinking alcohol, and using street drugs. For example, alcohol has a sedative effect that often dampens sexual interest and energy. In addition, a high-fat diet can block arteries and also clog pelvic blood vessels that aid the arousal cycle. The three major lifestyle causes of dysfunction in both women and men are:
Alcohol: People talk of going out to eat and drink, and then making love. Alcohol is perceived as “loosening people up” and making them more receptive to engaging in sex because it reduces inhibition. While it is true that a little alcohol, such as a glass of wine or a beer, can decrease anxiety and inhibition and generally relax a person, it can also depress sexual function and mood. Several drinks are likely to make someone sleepy and less able to actively participate in sex. In many men, alcohol may reduce the ability to have an erection and a climax.
Street and Prescription Drugs: Many prescription drugs available today lessen the ability and the energy to make love. Some drugs (both prescription and street drugs) increase desire and a sense of sensuality, but decrease sexual response.
Prescription drugs with sexual side effects include those prescribed to control cardiovascular problems (such as hypertension and angina) anxiety, depression, psychosis, and other conditions.
If you suspect that a prescription drug has side effects that affect your sexuality, check with your pharmacist and with your doctor. If this is the case, ask your doctor if there is an alternative medication that may not have this effect.
Cocaine, heroin, marijuana and other street drugs will distort sexual response.
Smoking: Research increasingly shows the direct cause-and-effect relationship between smoking and sexual function in men and women. Nicotine directly interferes with circulation and pathways of the nervous system. Smoking has a negative effect on the sexual organs, clogging small blood vessels and thereby reducing blood flow, including in the clitoral area in women and the penis in men.
Aging Affects Sexual Function
Even without cancer or other disease, as a person ages, sexual function and frequency of sexual contact often declines. Most women experience a decline in their sexual function as their bodies move toward menopause, and a substantial decline as they reach older age. Then there is the fact that the man is more likely to begin having erectile problems as he ages, and probably less sexual desire. As a result, a couple may have less sexual interaction over time.
Female Sexual Dysfunction
Within the context of cancer therapies, female sexual dysfunction (FSD) must be discussed as well. In the last half-century, substantial research has led to a clear definition of male sexual dysfunction, while women’s sexual difficulties were often dismissed as being “all in their heads.” Medical doctors were often quick to tell women to see a psychiatrist when they talked about sexual problems.
Only in the late 1990s and early 2000s did researchers document the spectrum of women’s problems that are caused by physical changes, as well as by psychological problems. The medical community has finally come to recognize female sexual dysfunction as a distinct medical condition.
It is estimated that as many as 43 percent of women suffer from some level of sexual dysfunction. Of women who have been treated for cancer, about two-thirds have short- or long-term sexual dysfunction. For some women, it was treatment that brought on their problems; for others, therapy worsened their difficulties.
Sexual dysfunction is not one problem but a spectrum of different conditions, whether they are the result of cancer therapy or not.
Low Sexual Desire
Women with this problem experience anxiety because they lack sexual fantasies or thoughts about sex. Women with cancer need to remember that fighting cancer may subvert or suppress sexual feelings. Sexual desire vanishes at least temporarily with some treatments. Medications may also cause this condition. A key factor in sexual desire is the quality of the relationship and its history, so problems in the relationship and emotional factors may also be responsible.
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