Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian homes. As a result, most people facing sexual health issues or trying to find information about sex often resort to unverified online sources or follow unscientific advice from their friends.

To combat widespread sex misinformation, publishes this weekly sex column, “Let’s Talk Sex”. We hope to start conversations about sex through this column and address sexual health issues with scientific insight and nuance.

The column is authored by sexologist Prof (Dr) Saransh Jain. In this article, Dr. Jain will discuss how lymphoma treatment can affect your sexual health and how to deal with it.

Lymphoma is a cancer of the lymphatic system. It develops in lymphocytes which are a type of white blood cells. These cells help fight disease in the body and play an essential role in the body’s immune defences. As this type of cancer is present in the lymphatic system, it can quickly metastasize or spread to different tissues and organs throughout the body. Lymphoma most often spreads to the liver, bone marrow or lungs.

When you are diagnosed with lymphoma, conversations about sex and intimacy are often not a priority. However, you may worry about how lymphoma cancer and its treatment will affect your current or future relationships and your sexuality.

Sexuality refers to physical, psychological, social, emotional and spiritual factors. This includes self-image, body image, reproductive capacity, emotional intimacy, sensual feelings, and sexual functioning. Your sexuality is an essential part of who you are, how you express yourself, and how you feel about yourself.

How does lymphatic cancer affect sexuality?

Lymphoma treatment can impact your ability to have or enjoy sex. Chemotherapy or radiation therapy near the testicles may have lowered your testosterone levels and/or damaged blood flow to the penis, leading to various sexual problems such as the inability to maintain a firm erection (also known as erectile dysfunction) , pain during intercourse, difficulty reaching or dry orgasm and loss of sexual desire.

Treatment (especially radiation therapy or intrathecal chemotherapy) near the brainstem can also damage the pituitary gland and reduce testosterone levels. You may also be taking various supportive medications such as pain medications that have left you with a lack of desire to engage in sexual activity. Additionally, other factors can impact your sexual health. These include your age, weight, blood pressure, drinking or smoking habits, and various psychosocial issues.

Sexual problems with lymphatic cancer

Problems related to sexuality can stem from the physical aspects of your illness or treatment, as well as the emotional aspects. Anger, guilt, or worry about illness and survival, treatment, or finances can also affect sexuality. Some physical or emotional effects disappear over time or when treatment ends, while some effects may last a long time.

Here are some issues you may encounter and suggestions to help resolve them:

Dyserection: This is usually caused by low testosterone levels or damage to blood vessels in the penis. See a doctor who has special training in treating male sexual problems. They may recommend drug treatments, vacuum devices, penile injections, penile suppositories, penile prostheses, or other alternative treatments.

Lack of pleasure and orgasm: Cancer treatment is rarely the direct cause of diminished pleasure or the ability to achieve orgasm. This can be caused by medications such as antidepressants. It can also be due to the emotions associated with erectile dysfunction or infertility. Ask your doctor or even a counselor to help you with these issues

Lack of desire, negative thoughts and feelings: Try to identify the cause of these emotions. For example, it may be caused by other feelings such as worry, pain, or fatigue. It can also be related to erection difficulties or a side effect of painkillers. If the latter, ask your doctor to suggest alternative supportive medications.

Other sexual problems: Other factors that can impact sexual desire and function include dyspareunia (low estrogen), vaginal dryness and there is also a possibility of re-emergence of previous STIs due to immune deficiency (eg. example, genital warts, herpes).

Psychological factors: There are various psychological factors that can impact sexual function such as:

  • High levels of anxiety, stress, worry or fear
  • Role changes (husband and wife vs patient and caregiver)
  • Loss of feeling relaxed and safe
  • Altered body image/poor body image (for example, hair loss, weight loss, weight gain)
  • Low sexual self-image
  • Previous negative sexual experiences

Adapting to a new “sexual” normal

Often, the negative impacts on sexuality and intimacy of lymphatic cancer treatment disappear after treatment ends. However, the impacts can sometimes last longer or even permanently alter your desire for sex and your ability to have sex or be intimate. For many people, adjusting to these changes can be difficult and can even cause friction in your relationships over time. If this is your case, here are some strategies and interventions you may want to consider implementing:

  • Consider pain relief and positioning
  • Create a relaxing environment for sex and intimacy
  • Focus on fun, not performance
  • Allow yourself to mourn the loss of familiar sexuality and sexual response
  • Practice talking openly about sex and your feelings with your partner.
  • Explore satisfying new sexual activity after treatment
  • Investigate the use of sex toys – vibrators, dildos, lubricants

Many people find it difficult to discuss their sexual concerns with others; however, your doctor or a sexual health specialist can help you overcome these issues. These healthcare professionals can recommend advice, medication, or surgery to help you.

Communication with your partner or a potential partner is also important. Sexuality is an essential part of your quality of life after your experience with lymphoma. Break the pattern that sex should lead to penetration and orgasm. Keep in mind that it is possible for both men and women to feel sexually satisfied and bonded through a non-orgasmic experience. Consult your doctor to rule out any physiological problems. A sex therapist can help solve certain difficulties.

Prof. (Dr) Saransh Jain is the Swasth Bharat Rattan Award winner and is a certified and licensed sex therapist by the American Board of Sexology. He is currently a Senior Consultant at Dr. SK Jain’s Burlington Clinic in Lucknow. The opinions expressed in this article are those of the author and do not represent the position of this publication.

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