Big O

Vol. 6 - Rediscovering Sex

If you were orgasmic before treatment, you will most likely be able to achieve orgasm afterwards, but it might take more work. So, ladies... this one is for you... and for the guys who want to encourage desire and achieve orgasms.

Oh, but I have Sex-Anxiety...

Some people have an anxiety about sex... especially after cancer. So much has changed, both physically and mentally. There is the pressure to satisfy your partner. There is pressure that your partner may not find you attractive anymore. There is pressure that you may not find you attractive any more. There is pressure to... insert anything here!

After everything you have gone through, you now have to rediscover yourself. (Read this blog post about self-discovery and acceptance.) Not only do you have to know what you like, you need to facilitate open and positive communication with your partner. (Read this blog post about how to talk about sex.) Yet, there can still be a lingering concern about sexual satisfaction... both for your partner and yourself.

Your sexual response and ability to orgasm may have changed... and it may have been due to the variety of breast cancer treatments endured. It could be the loss of breasts as a sensual organ or hormone-induced menopause blocking easy orgasms or nerve damage preventing pleasure. There are so many things that cancer treatment can due to your sexual response. I know mine changed!

I'm orgasmic... I think?!?!

There are some things to do if you have had an orgasm at some point (even prior to cancer) or if you are wanting to find a way to achieve orgasm. The majority of women who have achieved orgasms have done so from direct clitoral stimulation. Do orgasms happen from penetration alone? Sometimes for some women, but not for most women. Do orgasms happen from the G-spot? Sometimes for some women, but not for most women.

Stimulating the clitoris before or during sex is the best approach. (Read this blog post for specifics on anatomy and orgasms.)

Time to Touch

Masturbation is a normal and positive sexual experience for most people. It is unfortunate that there is shame and stigma associated with it. Research has provide insight into the fact it is a common sexual behavior for people. And surprise... it is more common for men... which is a disappointing because expecting your partner to know what satisfies you when you do not even know is unfair.

Take time to touch your genitals, as well as try different touching methods, pressures, or even different hands... you can even masturbate while having sex. Explore your body. You need to find out what areas are pleasurable now. Avoid areas that cause pain... but occasionally retouch them as it may change over time.

If you are nervous about self-stimulation, then plan for a time when you know you will not be interrupted. If you are not, then include your partner so they can learn what you like or dislike. Do not do anything that makes you uncomfortable, and hopefully, over time, you can learn to be comfortable with this type of sexual experience.

Learning what helps you achieve orgasm will enhance your sex life. It may also encourage your sexual desire. If you don't use it, you may lose it... so keep trying!

What are some ways to help if you are struggling to reach orgasm?

• Fantasy. You may need to use your mind and think about past experiences or about daydreaming to help distract from negative thoughts or pressure to perform.
• Toys. Using vibrators or other devices for extra stimulation might help reach orgasm easier. You can use it yourself or your partner can use it on you!
• Foreplay. It is all about the foreplay for the ladies. Remember it is clitoral stimulation that helps achieve the majority of orgasms. So, devote some time to it... with your hand or orally.
• Positioning. We often have sex in the same position, whichever one we enjoy the most. However, after cancer treatment you may have to find a new position, so be creative in your sexual positions. Try different positions to see which one works for you. Remember, there is no right position or right way.
• Your Thighs. In addition, try tensing your thigh muscles with your thighs open vs. thighs close... every one is different, but some women respond to one of these options.
• Kegels. Tighten and relax your vaginal muscles during sex or during clitoral stimulation.
• Breathing. Take longer breaths and try to match them with the Kegel rhythm... inhale as you contract your vaginal muscles & exhale as you relax them.
• Environment. Create a relaxed and sexual mood... light candles... play music... use food... basically, encourage your senses.
• Timing. A lot of people believe sex has to be spontaneous to be fun and romantic. This is a misconception. Making a date for sex may be just what you need. You are guaranteed the time you need to encourage foreplay and sex. 
• Working together. Make sure to experiment with your partner and find the type of touch you like!
• Resources. You may want to find aid in sexual satisfaction... movies, literature, or self-help books... but just keep trying.

I'm Not Ready... or Maybe I'm Ready

You may need to experiment with a gradual approach into your sex life. One way to do that is through Sensate Focusing. This is basically touch therapy, where you limit the first few sexual experiences to just touching. It focuses on devoting your experience to all-over body touching. It helps take the pressure off the person worried about sex.

Touch is an important part of sexual arousal. Learning what type of touch is stimulating may take more time than you think. Cancer may affect you in a way that associates touch with pain. Plus, you may experience exhaustion making the idea of sex tiring before you even begin. This might be the best way to restart your sex life, if it is has stopped.

Take it slow. Make sure to communicate with your partner and let them know you want to have sex again, but may want to work into it slowly. Let your partner know that it may not go smoothly, but you are willing to try.

The goal is to be self-less and learn about what each person enjoys... when you are the one touching. The goal is also to be self-centered and learn what you enjoy... when you are being touched.

Sensate Focusing

The very first touch therapy approach avoids the breast and genitals, encouraging a relaxed sensual experience. Basically, this session is where each partner takes a turn being touched learning ways you both enjoy being touched.

Make sure your partner knows there will be nothing but this type of touching... NO SEX. This is important because you do not want the touch to cause frustration, but focusing on creating a closeness with your partner.

Here's what you do:

1. One partner lies face down allowing the other person to touch them from toe to head for 15 minutes. Describing the sensations and noting what is pleasurable.
2. Then they flip over lying face up allowing the other person to touch them from toe to head for 15 minutes. Describing the sensations and noting what is pleasurable.
3. Now do the same thing, but for the other person.

When you are the one being touched do not think about what your partner is thinking, but focus on the pleasure you are receiving. Your goal is to relax and enjoy the experience.

When you are the one touching focus solely on your partners pleasure. Try different types of touching from light stroking to firmer massage style touch. Your goal is to find ways to please and connect with your partner.

Once you are both relaxed and willing, repeat the same process, but add the genitals and breasts. This can take multiple sessions/days/weeks. Continue these types of sessions focusing on genital caressing and stimulation until your partner is able to reach orgasm. Express what type of touch you like and guide your partner, so they can please you. Things like oral sex can be added when both partners are ready. Or move to the shower and experience touch in the water. Remember, work gradually up to penetration.

I know I keep saying it, but communication is key... it is an important part of having a healthy and satisfying sex life. Make sure to communicate in a positive way encouraging your partner.

I'm not interested... what do I do?

Believe it or not, a lot of women feel this way... or we get so busy or so sick we put our sex life last. Sometimes we just feel a lack of desire. It may be helpful to encourage your positive sex thoughts. Essentially, redirecting our focus on sex and desire. One way to do this is to keep a journal or your desires for a week.

Keep your journal handy (or use Notes on your phone). Write down every time you have a sexual desire, thought, or feeling. Note what it was, as well as the time and who was with you. Use this journal to look for patterns. Is there a time you are more aroused? Is there a setting? A person? You can start understanding more about what turns you on. Then use that knowledge to help encourage your sexual interest.

You should have a better understanding of the things that turn you on. Now plan times with your partner based on this information. Also, make sure you have taken an extra effort to look sexy.. to feel sexy. It can be an evening out or in. It can be dinner or a movie. You can be reading a smutty book out loud. You are only limited by your imagination. Use your insight into what turns you on and encourage your senses to be aroused. Take what you have learned about yourself and make it a reality with your partner.

Final Thoughts

It is easy to say sex is not important or can wait, but it is important and it enhances your relationship. There were times that cancer made me exhausted and self-conscious. And there were times I would have to be creative to be satisfied and other times I was just practical. I remember saying to my husband, "You have 15 minutes to do whatever you want... as long as I don't have to move." So, on days where you just don't care about your own pleasure, but do care about your partners - embrace the quickie!

Remember there is no correct or right way to find a satisfying sex life. Sex is fluid. How you feel today does not predict how you will feel in the future. Just keep trying. And remember to always talk to your doctor - sexual health is part of overall health!