Sex is important to health, especially when your wife has cancer. But don’t expect it to be the same as it was before.
Does your wife just want to cuddle, or does she really want unbridled sex? Maybe something in between? Not to minimize your desires, but what do you really want?
We’ve all experienced it: In a loving, committed, intimate relationship where each partner is healthy, the two don’t always want the same level of affection or intensity of sex. Sometimes he wants it when she doesn’t, and sometimes she wants it when he doesn’t. When your wife has cancer or another serious illness, these same two truths of sex will still apply, but some of the reasons are a bit different.
My wife Mary and I had good communication and mutual respect in our marriage. This helped us have a healthy, satisfying sexual relationship in the years before she was diagnosed with cancer. When she started her cancer treatments, we had some adjustments to make, in our thoughts and our sexual activity. I learned that it’s very important for the husband as caregiver to help his wife lead as normal a life as possible. This includes sex. But when one partner is dealing with cancer, especially when they are going though treatment for cancer, sex requires you to think about things you haven’t thought about before.
The immune system is hard at work when a person has any serious illness. More so during chemotherapy. This means it is particularly important that you wash your hands and scrub your fingernails before your sexual interlude. Bacteria on your hands and under your fingernails can create an infection for her that she can’t fight.
Talk with her doctor or oncology nurse about whether or not it is recommended that you use a condom. Certainly you should if you have an STD that she does not have, or if you have a urinary tract infection. You should also use a condom if you’re having sex with your wife while she is receiving chemotherapy.
The medical team didn’t talk about this back when Mary was in treatment, but I recently learned that bodily fluids including vaginal secretions have traces of chemotherapy drugs after treatment. In addition to wearing a condom for intercourse, it may be recommended that you avoid giving her oral sex during and minimally 48 hours after her last chemotherapy treatment, or use a dental dam. If you aren’t familiar with dental dams, do an Internet search for “dental dam for oral”. The Idaho.gov site has good information.
Unless you’ve had a vasectomy or she is not able to get pregnant, also discuss the effectiveness of the birth control method you were using most recently. Using a condom may be the best option for birth control if your wife is receiving chemotherapy.
Your sexual relationship with your wife while she is in treatment will largely depend on the foundation of communication, trust, and play you two built when she was healthy. If that foundation was less than ideal, you have an opportunity now to improve honest communication, which will help build trust, increase romance, and maximize sexual pleasure for each partner.
It will help your wife’s health, your sanity, and your marriage if you are aware of and sensitive to subtleties in her communication with regard to these two truths:
Truth #1. Your wife may want sex when you don’t.
Not possible, you think? Guys, most of us are visual. Imagine your own wife’s healthy body with her curves in all the right places, and the parts of her body where she loves you to touch, and kiss. You get rev’d up when you see her giving you that look that says she desires you.
Reality hits: She’s sick and she doesn’t look like the woman you were first attracted to, nor a reflection of the one you’ve grown to love unconditionally. She’s swollen from the chemotherapy and may even have a degree of organ failure. She has scars and a port and sometimes smells bad, noxious from the chemo. But she’s telling you in words and acting as if she wants sex from you.
Performance anxiety is something all men experience at some point, and this is likely to be one of them. One time we were ready to go the hospital for Mary’s bone marrow treatment. I was about to cry because I was afraid she would die, yet Mary wanted sex. Talk about performance anxiety!
You love your wife, so it’s easy to be affectionate, but right now you are not attracted to her in this condition. Under these circumstances, getting and maintaining an erection is nearly impossible.
How you can help.
Start slow, and talk with her while cuddling. She may be expressing desire simply to please you, in her mind helping to ensure you don’t wander to find another lover, and leave her. She may have read how a large percentage of husbands leave their wife once she is diagnosed with a serious illness. The statistics are not pretty.
Reassure her you are going to stand by her side— “until death do us part”—but only if you mean it. Remember, honoring your commitment “in sickness and in health” means the whole spectrum, including when she is sick!
The situation is not the same for men as it is for women. When a husband is sick or stressed and experiences erectile dysfunction and related issues of deflated self-worth, the wife usually sticks with him. Men statistically run or cheat when they are not getting sex in their marriage.
Foreplay is more important than ever, for each of you. Foreplay will help her relax and warm up to feel loving and sexual, to get naturally lubricated and possibly receptive. However, there is a possibility that she will not be able to enjoy intercourse, and “foreplay” will be the main event. With careful attention, you may help her achieve orgasm.
Foreplay will also help you to release the stresses of being caregiver and allow you to resume lover mode, which will help your arousal to orgasm.
If she does want intercourse once the two of you are warmed up, use your vivid imagination to visualize the healthier version of her body that used to drive you crazy with desire. This will help you maintain your erection.
Be gentler than usual, and use your finger first. Still, when you penetrate her, she may find it uncomfortable or even painful. If that’s the case, or if you are not able to maintain an erection, you can still pleasure each other by other sexual acts that are mutually agreeable. What you do together sexually will depend on the foundation of communication and the sexual preferences and boundaries the two of you established earlier in your relationship.
If your wife expresses an interest in giving you oral sex, enjoy! Just be sure not to thrust into her throat, even if she enjoyed that when she was well. Let her take the lead here and you’ll know that she won’t take in more than she can handle. This is especially important if she has been nauseated during her treatments.
Truth #2. Your wife may not want sex when you do.
Don’t let it bruise your ego. She may want to give you pleasure and simply not have the strength. Cancer, and more so the treatment for cancer, drains a person’s energy. It is also possible that she may anticipate pain.
Elasticity of skin weakens, including the vaginal walls. Dehydration from radiation and/or chemotherapy can cause vaginal dryness and clitoral irritation. Lubricant products may help, but be aware not to use a product that has alcohol in it, which is true for many lotions. Alcohol will sting her if she has any lesion of the skin.
How you can help.
After Mary had her mastectomy, she didn’t achieve orgasm for a whole year. During that time she wanted to give me pleasure. Even when she was not able to enjoy intercourse, we used other means, such as oral sex, toys, lotions, etc. How this works for you depends on your communication with your wife and the sexual boundaries the two of you establish.
Ask her to let you know what she wants sexually and feels that she will enjoy. Giving her oral sex may help her to warm up and get naturally lubricated. It may also help you to lose yourself in giving her pleasure, or fantasizing about your earlier lovemaking sessions.
Pay attention to her words and body language: If she does not show any interest, or if she did at first but now seems to have changed her mind, stop for now. Try with her again when you see she is feeling better or when she initiates. In the meantime, give her affection if she wants your touch, and show her that you will respect her boundaries.
Talk about sex and the thoughts and feelings each of you has about it while you are alone together in a non-sexual way, such as when the two of you are in the kitchen, or relaxing on the couch together. This may remove any performance pressure and invite honest communication. Ensure there is no distraction so you can be fully present, giving each other your undivided attention.
As your wife’s caregiver, it is important as much as possible to help keep normalcy in her life and yours while she goes through cancer treatment. Whether or not sex is a safe and welcome option for her, affection is important for her physical healing and emotional health, as well as your mental-physical health and connection with her. Communicate, and remember your unconditional love and commitment to your wife and your marriage.