BarcelonaWhen Rebecca Stewart began chemotherapy to fight breast cancer, she did not know that her sexual desire would almost disappear after three months, that she would be unable to lubricate, or that her vagina would contract to the point of not being able to enjoy penetrative sex. “It was as if my body had closed to sex even though my head wanted it. I didn’t know if that was normal or if it would go back to being what it was before,” he says. During the first sessions of the treatment, which ended up taking six months, her oncologist prepared her for hair loss and nausea, but Rebecca, then 29 years old, was not told that her sexuality would suffer so much. Nor to Marta, who was 48 years old when she was diagnosed with a breast tumor. Her libido plummeted and she was outright rejecting the idea of sex after starting treatment. “In the consultation no one mentioned it. It was not until they referred me to the psychologist, because my social relationships had been greatly affected, that we also addressed the effects of therapy on my sexual life,” he recalls.
All women who receive treatment for breast cancer, be it chemotherapy or hormonal therapy, experience biological and physical changes, but also emotional ones, which make them lose their sexual desire or make it impossible for them to have an active and pleasant sexual life. These treatments reduce the estrogenic stimulus and, in practice, cause early withdrawal of the rule. “The woman enters a phase of menopause: her period goes away, she has hot flashes, vaginal dryness, low libido and loss of vaginal elasticity. Sex hurts”, explains Sònia Servitja, section chief of the oncology service Hospital del Mar doctor. And all this has a common denominator: drugs that cure cancer destroy much more than cancer cells.
These problems are suffered by 99% of patients, but they are almost never reported in advance from the medical services. Sexual side effects caused by cancer treatments are also not included in the documentation sent to them, even though you are supposed to prepare them to understand what to expect from the beginning of therapy and how they can act accordingly. Due to ignorance or lack of professional support, therefore, many women end up normalizing them or assuming them as irreversible. “Professionals should be the first to train and be informed about it in order to convey all the information about their health. Just as we recommend taking Primperan for vomiting, we also have to be able to refer them to specialists, such as sexologists, who can help them. with the problems that have to do with their sexuality, “says Servitja.
Marta believes that the problem is the gender bias in society, which also influences the self-perception that women may have about sex or the importance that they have been instilled in it. “Socially, it is assumed that a woman’s sex is secondary,” he says. She herself at first avoided it: she believed that it was not important, compared to the diagnosis. “It was a very traumatic blow that caused me depression. But when I was more animated because the treatment was going well and I was moving forward, I wanted to recover aspects of my life that had been relegated, such as sex, and I realized that I had to look for them to generate situations of well-being and sexual health, “he says.
“It is unthinkable that a man does not experience an erection, but it is irrelevant that a woman cannot even masturbate” ”
Rebeca Stewart Breast cancer patient
For Rebecca, men and women are not treated equally in similar situations. “When a man visits the urologist for prostate cancer he receives Viagra and in the consultations they talk about sexuality, or how the treatment can affect their erections. Not women,” denounces the British woman, who assures that the message that is sent is that the sexuality of the woman is secondary or directly non-existent. “It is unthinkable that a man does not experience an erection, but it is indifferent that the woman can not reach orgasm or can not even masturbate,” he claims.
Given this, Rebecca, who is a scriptwriter and director of feminist erotic cinema for Erika Lust’s production company, stood up: she recorded an erotic short film that deals with the impact of breast cancer treatment on female sexuality. Called Wash me, explains your personal history as a patient and the process toward recovery from the disease. “With this short I wanted to raise awareness and start a conversation. For women who go through a situation like mine to talk to their environment, their partners and their doctors,” he explains. The movie can be watched for free here and, for each entry in the link, one euro will be given to the Hospital de la Mar for breast cancer.
Servitja argues that the root of the problem is that female sexuality continues to be a taboo, especially among older women, who due to shame, ignorance or even ideology, do not even consider that sex is part of their health. “Society is sexist and the pleasure of women and their sexual health have always been invisible,” he laments. “It is necessary to normalize sexuality, understand it as one more part of human relationships and as a dimension that does not have to be renounced due to the fact of going through or having undergone an oncological process,” agrees the psycho-oncologist and oncosexologist Rosanna Mirapeix.
Sònia Servitja Director of Medical Oncology at Hospital del Mar
Rebecca also uses the word taboo. “I believe that women with breast cancer face a triple taboo: women do not talk about sexuality, women do not talk about female sexuality and women do not talk about sexuality if they are sick.” In the latter, he points out, there is also the perverse idea that a patient only has to worry about surviving, but not about living or doing it with quality of life.
Sex is not only a way to have fun, but it is also a tool for empowerment, increasing self-esteem and reconnecting with oneself after having lived through an episode as distressing as overcoming cancer, the experts emphasize. “There were days when I thought that my body was failing me, that it was going against me, and I hated it because it made me spend hours in the hospital – recalls Rebecca – but sex and sexuality helped me to remind myself that I was still alive and that my body could give me pleasure, not just suffering. ”
The magic solution to regain libido or make sex more pleasant does not exist, but there are resources to improve sex and learn to enjoy, such as the use of lubricating gels, dilators and Kegel exercises, as well as the psychological and emotional therapy. And above all, a lot of patience with oneself and a lot of communication with sexual partners.
“Let’s not be reductionists: sex is not just penetration”
In case there is a lack of desire or some problems such as pain during intercourse or lack of desire are suffered, the psycho-oncologist and oncosexologist Rosanna Mirapeix assures that it is possible to reach orgasm. To begin with, he recommends, those practices that are known to cause pain should be avoided from the outset. “If you know that when they penetrate you they will hurt you, not only will you not be able to enjoy the moment, because you will not be able to let go of the pleasure, but it is very likely that your brain will give your vagina the order to close and everything will be more complicated “, Explain.
In this sense, he says, communication with the couple is basic. “We have to know and share our concerns, fears, and sexual preferences. And above all, let’s not be reductionist: sex is not only penetration, we have to learn to enjoy it in other ways, ”he says. However, Mirapeix clarifies that this does not mean that intercourse has to be renounced, but that it can be introduced little by little and without haste. “All of this implies a lot of will on the part of the patient, especially to regain libido. It is not easy at all, and therapeutic failure is quite high ”, he warns.