Some people worry that they will hurt their partner. Telling them where and how to touch or moving their hand to avoid pain and find the most pleasurable spots will get around this anxiety. During and after cancer treatment it is common to feel weak and tired. If this is the case, it may help to ask your partner to take a more active role than usual in lovemaking.
No matter what kind of cancer treatment, the ability to feel pleasure from touching almost always remains. Some will need to learn new techniques or, in the case of gynecological surgery, may even need to relearn how to have orgasms. Keeping your options open means maintaining an open mind about ways to feel sexual pleasure. Many people have a narrow definition of ‘normal’ sexual activity. As an example, it is not uncommon for some people to think ‘sex equals penis-in-vagina intercourse in the missionary (what do you mean there’s more than one?) position.’ This restricted attitude stands in the way of sensual fulfillment.
Using fantasies of happy memories or special places will distract you from the fears and unpleasantness of the realities. Taking time to explore sensitive parts of your body or playing around with a vibrator will increase stimulation. Trying out different positions to avoid pain and using lubricating jelly to get around vaginal dryness will help to overcome some of the discomforts.
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In some cases sexual disinterest is a longterm prospect. Emotional factors are high on the list. Chronic depression or stress are frequently associated with loss of interest in sex. Alan became depressed after a series of business failures when he was in his thirties. ‘At the time I just wasn’t getting any sleep. I had so much on my plate that months would go by when I hardly thought about sex at all. It wasn’t until I saw the light at the end of the tunnel when things started to improve at work that I realized how little interest I had had in sex.’
How interested you are in sex depends heavily on the target of your affection. Sexual chemistry is a funny thing. ‘Chemistry’ implies a cocktail of ingredients — triggers — that set off another person’s sexual interest like a smile, a perfume, hair color, body movements. Romantic poets depend on it. No scientist has been able to explain it. It defies logical definition, yet it is such a vital element in any successful sexual relationship. Two people can be totally compatible as friends, enjoying each other’s company and sharing the same interests but if that intangible we call chemistry just isn’t there, then libido might be a bit evasive.
Being with the wrong partner can be the reason for a relatively lower interest in sex but consider the effect of partners being the wrong gender for you. The possibility that you are not interested in sex because you would actually prefer a partner of the same gender can be immensely confronting, particularly as it goes against the grain of a lifetime of conditioning. This rarely becomes an issue until strong sexual feelings are ignited by a person, an event, or a fantasy. And it can come as quite a shock, as it was for Kate.
‘I remember, as a teenager, having crushes on older girls at school but that wasn’t anything unusual amongst my friends. I started dating boys when I was about sixteen but I wasn’t really that keen on the whole process. When I met my husband we got on incredibly well together and I knew I was in love with him but I always had the feeling there was something missing. Although I didn’t avoid sex with him, I certainly didn’t initiate things very often. My girlfriends had always been very important to me but when I met Marie it was totally different. It sounds like a clich? but it was like I had been hit by a bolt of lightning. I remember being acutely aware of an intense sexual attraction between us and thinking, «I don’t want this to happen; it’s just too hard», but it was impossible to stop the feelings. My libido felt like it was turbo-charged, and I realized this was what I really needed.
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One woman who has endured four miscarriages told me, ‘Anyone who thinks life doesn’t start at conception has never had a miscarriage. Actually, the first one wasn’t so bad. It didn’t really connect for me that it was a baby I had lost … more like a blood clot or something … and I explained to myself that there must have been something wrong with the baby. Nature’s way of getting rid of abnormal babies … you know what people say to try and make you feel better. After I had my first live baby, my attitude really changed. It was much more real then. I wanted a big family more than anything in the world but I had three miscarriages in two years. The first went to sixteen weeks and the next two only lasted twelve weeks. Each time I had a miscarriage it was as though I had lost a baby at full term. It’s impossible to describe the pain of the grief. Lying in the hospital ward with a drip in my arm before the curette, it was so lonely. The staff were trying to be really understanding, but to them miscarriages were so commonplace that they were just a routine. I thought if one more person says «Better luck next time» I will just scream! One strange thing that happened each time I got pregnant was that I became incredibly protective of myself and the baby as a unit. I wouldn’t let my husband anywhere near me. Sex was out of the question and my only priority was getting the pregnancy to term. I wouldn’t do anything that would disturb the baby. I would cringe even if he wanted to give me a cuddle because I’d think, «Oh no, he wants to do it!» I really felt like I was being attacked.’
The harder it has been to get pregnant or to take the pregnancy to full term, the stronger this siege mentality gets and it really is understandable. In fact women with a history of repeated miscarriages may well be advised to avoid intercourse for the first few months of the pregnancy as a precaution, although most will do so anyway as an instinct. This is one of those situations when it is important that the woman’s partner understands the reasons the advice has been given. That makes it a team effort for a common goal, rather than the man feeling totally shut out of the pregnancy. I’ve heard it said that the Freudian concept of ‘penis envy’ is just a decoy invented by men to take the attention away from their ‘womb envy’, an unfulfilled desire to experience pregnancy for themselves. The point here is that the more pregnancy is treated as a team effort the less likely you are to run into problems, and that means men being involved and informed as much as possible at every stage.
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Another case where a secondary relationship can develop is when one partner becomes seriously ill or permanently disabled to the point where a sexual relationship is no longer possible, as in the case of advanced AIDS-related illness. The other partner takes on the role of carer and may remain deeply committed but establishes a separate sexual relationship.
A secondary relationship may also reflect a person’s lack of self-confidence — asking themselves if they are still sexually attractive — but it can also be a sign of a relationship in trouble. If a person is considering leaving their partner, they may well be looking to establish another relationship before they finish it. You could call it the ‘Tarzan Tactic’. Imagine Tarzan swinging through the trees from vine to vine. He won’t let go of the last vine until he has a firm hold on the next.
There is no question that the disclosure of a secondary relationship can leave a partner feeling shocked, betrayed, jealous, angry and hurt. It is frequently the cited cause of relationships breaking up but does this necessarily need to be so? It can be a good time to reassess the whole relationship.
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It is often said that there is no such thing as totally safe sex (except masturbation on your own) and that the campaigns to increase condom usage fail to take into account that condoms can break in action. They even changed the expression ‘safe sex’ to the more accurate ‘safer sex’. It’s true that sex education is still in a process of evolution and we need to know where the misunderstandings are so that the information can be adjusted to account for them. Moreover, it is becoming more and more obvious that safer sex instructions need to be detailed enough so that there can be no room for error. It is not enough to say ‘use a condom’ without making it clear that putting it on at the last minute, just in time to catch the ejaculated semen, may be too late. Many people don’t realize that you needn’t actually ejaculate to pass on an infection. In particular syphilis, genital herpes and warts just need skin to skin contact, so for protection the condom needs to be put on before there is any genital contact at all.
It also helps to know things like how to put a condom on and take it off again correctly, that you need to keep squeezing the teat, at the end until the condom is rolled right down to the base of the penis, and that using a water-based lubricant helps to prevent the condom from breaking.
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