Let's Talk About Sex (and Cancer)

Sex. Oncologists rarely talk about it, but patients and their partners want to know how to prioritize intimacy during surgery and treatment. How can you maintain some sense of sexual normalcy in the midst of all the changes?

Part of the appeal of Sex and the City was that women could identify with the characters. I was no exception. I blogged about my dating life like Carrie, possessed Charlotte's idealism, was a redheaded attorney like Miranda, and was extremely comfortable with my sexuality like Samantha. In 2010, I was chosen as "Samantha" in a Sex and the City DC contest.

Shortly after the contest, I was - like Samantha - diagnosed with breast cancer.

I knew that treatment would be tough, but I didn't realize how tough. I lost my signature locks, required 20 extra days of IVs to combat the side effects from chemotherapy, was thrown into menopause, and gained 23 pounds from the steroids.As much as treatment affected me, I needed to maintain some sense of normalcy in my life. Continuing to prioritize my sexual health was a key part of that.

How can you preserve your normal sexual routine during cancer?

1. Talk to your doctor. Once you know the treatment plan for your individual case, ask your doctor about any sexual restrictions. Specifically inquire about each sexual activity that you enjoy so you know exactly what you're allowed to do and not do. If you aren't sure how to talk to your doctor about sex, check out my tips for initiating that conversation.

2. Assuming there's no medical bar to you achieving orgasm, listen to your body and don't push it. There will be some days throughout this process when you feel stronger than others. Try not to put pressure on yourself to orgasm as quickly or as often as you previously did.

3. As you try to process all the changes to your body and psyche, give yourself permission to feel angry, sad and overwhelmed. Ask your oncologist for a list of support groups or counselors, talk to friends or former patients, become active in online communities, or journal about your experience to help you process.

Strategize about what you can do to feel better about yourself, including what you can highlight or wear to try to feel sexier in the midst of everything. (In this instance, faking it until you make it is encouraged!)

4. If you're in a relationship, it's critical that you communicate with your partner during this time. He or she might not understand how treatment affects your body, self-image and sex life.

If you're unable to have sex (because of pain, lack of drive, or doctor's orders), think of how you can remain connected to your significant other. Kissing, cuddling, massages, candles or bathing together are great ways to maintain a level of intimacy with your partner during a health crisis.

When you are able to have sex, talk to your significant other about what positions are the most comfortable for you. Let your partner know that you will need to be treated with extra tender loving care in the bedroom and speak up the moment that anything hurts. Both you and your significant other will need to be patient to help you reach orgasm. If you've been fighting nausea, keep mints on your nightstand to make the experience easier to stomach. It's also advisable to invest in a high-quality lubricant like Liquid Silk or Sliquid to ensure that sex isn't painful.

5. If you'd like to have as much sex as possible during treatment, and your doctor is okay with that, then please do so! Likewise, if you don't feel up to having sex at all, then go with that.

Cancer will put enough of a toll on you physically and emotionally so there's no need to add to your stress and frustration. Go easy on yourself and do whatever feels normal and natural to you. If you aren't sure what to do, talk to your doctor, a nurse, support group, and/or your partner. There are resources and reinforcements out there to help make this difficult time easier to bear - physically, emotionally and sexually.

How did you prioritize intimacy during surgery and treatment?