Both the diagnosis of ovarian cancer and being treated can affect a woman's sexuality. Women are usually advised to wait at least six weeks after a hysterectomy before having intercourse, and naturally, many women worry about resuming sexual activity. However, some felt it was important to start having sex again because it is a positive part of being close and they did not want to lose this part of their life.
Some women were concerned that their partners might no longer find them attractive because of changes in their body such as the loss of their female reproductive organs, surgical scars, weight gain or hair loss (see 'Body image'). Women who had lost their hair sometimes wore a wig in bed with their partner. Other women were concerned about the possibility of physical changes to their vagina resulting from surgery that might make sex less comfortable or change the sensations they or their partner felt. One woman said that, whilst her husband insisted he was still attracted to her, she no longer saw herself as a sexual person because of the changes to her body. Because she felt more spiritual, and less physical, she had wondered about exploring Tantric sex (an Eastern influenced form of sexual connection that emphasises emotional rather than physical connection) with her partner, but he had yet to be convinced.
Feared that her husband would no longer find her attractive because of her operation scar, but he...
Feared that her husband would no longer find her attractive because of her operation scar, but he...
Age at interview: 59
Sex: Female
Age at diagnosis: 58
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My biggest fear was when I first came out of hospital with this terrible scar, you know, I thought to myself, you know, 'it's awful', it was dreadful, 'how will he ever want me again?' You know what I mean? But he's been very understanding, my husband, whereas a lot of husbands wouldn't be and it has not bothered him at all. You know, he said 'as long as you're all right and you're still with us, I'm not worried'. He said 'I just want you to get yourself better.'
Felt unattractive and wore a wig in bed but feels that a sex life needs to be preserved.
Felt unattractive and wore a wig in bed but feels that a sex life needs to be preserved.
Age at interview: 61
Sex: Female
Age at diagnosis: 54
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My own image of my body was horrendous for weeks and weeks and my husband was always very reassuring and he would say to me 'you don't have to wear your wig, you know', when we went to bed. And you think 'well it is a bit silly isn't it wearing a wig in bed' but, you know, you're... I was so thin and scrawny and, that you don't really feel attractive even if you felt you had the energy for a wildly exciting sex life, you don't, you, you often have to make yourself remember that this is quite an important part of your life and that if you don't preserve it, it isn't going to come back when you feel alright.
I think that's really the way it's affected it, that often you maybe find yourself perhaps with less enthusiasm than you might have, but you know there is going to come a time when you are going to feel better, but as you get older you might think, 'gosh I let this go' and so perhaps more self-consciousness about it. But mostly, largely because it's very difficult, it's been very difficult for me to think that I want to be seen outside of voluminous night-dresses or pyjamas, you know, terrible, pancake bottoms and things.
Thought that surgical changes to her vagina would make having sex difficult, but it felt normal...
Thought that surgical changes to her vagina would make having sex difficult, but it felt normal...
Age at interview: 43
Sex: Female
Age at diagnosis: 41
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After I had my treatment I was, at first I was told they were going to leave the cervix. And then I was told that the cervix had been taken away, so I wouldn't have to have any more smear tests or anything. But then, not really being a medical person I didn't quite know what was going to happen then if I did have sexual intercourse, because would the vaginal channel be big enough, for one thing, or would I tear? Or I didn't know what was at the end of it. But I was told that, yes it would, it was quite sufficient, it would be long enough to take the length of a penis, if you see what I mean.
And the first time I was a wee bit wary of it because I was scared that I was going to burst or, you know, it would be to the end and I kept asking, 'What does it feel like to you? Do you feel you've come to a barrier or something?' But I mean you don't, you just feel normal, to them, you know, to the male. They didn't find anything different about it. It's just in your mind you're expecting like the finger of a glove, that you come to the point at the end of it and you think, 'oh it doesn't go any further', it doesn't work like that. So you do have plenty of space, but then I didn't know that, I was quite, quite unsure of what they had done.
No longer felt she was a sexual person after surgery, though her husband was still attracted to her.
No longer felt she was a sexual person after surgery, though her husband was still attracted to her.
Age at interview: 44
Sex: Female
Age at diagnosis: 36
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Okay. I think initially, again I felt so ill from the surgery and the chemo that it wasn't really an issue. I completely lost my libido but then I assumed it was because of all the treatment I was having. Unfortunately it didn't come back. It wasn't until quite a long term after the surgery that I realised they'd removed quite a bit of my vagina, and that did have a profound impact on me sexually because I didn't feel like a whole person. It hadn't bothered me having my uterus removed but when I found out some of the vagina was gone that, it did affect me. I just had no libido at all because I didn't feel like a sexual person any more.
And so that's been a very, it's been a problem for us because my husband has been very keen to show all the way through that it's not affected his, he still feels very attracted. And, you know, he feels it's important to let me know that he does, and he's been a real sweetheart that way. But the problem is I don't want to know. I think I just feel that my body is just been so broken and beaten that I find it hard to think of it as something to celebrate, and I think my sexuality was very wrapped up in that. And I just don't really have any more because of that.
Women may also feel less interested in sex because of the effects of treatment. Both chemotherapy and hormonal changes brought on by removal of the ovaries can cause loss of libido, and many women said they had not had sex since their illness. One young woman said that she didn't see the point now that she was infertile. Some said they had had sex but it was painful or uncomfortable, or they had bled as a result, so they did it less often than before their illness, or found other ways to be intimate with their partners.
Had no sex since her illness due to a total loss of interest in it, and her husband was supportive.
Had no sex since her illness due to a total loss of interest in it, and her husband was supportive.
Age at interview: 65
Sex: Female
Age at diagnosis: 59
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Given that you'd already had a hysterectomy years before you had your ovaries out, it probably didn't, the extra surgery probably didn't have an effect on your sex life or anything?
No it didn't, but I did find that after the chemo, even now, my body's just gone dead. And they did say that does happen sometimes. But my husband is very good, very patient and I find it even now sort of there's just nothing there. So we're just sort of very, very, very good friends now. I did mention it to the doctor and he says it does happen sometimes to people or you can get therapy treatment and he said 'do you want it or are you quite happy as things are?' So I said 'well, I'm quite happy as things are but I don't know about my husband'. And I spoke to him about it and he said 'well, I've got you, that's all that counts.' So we just plod on.
Found sex uncomfortable after her treatment so found other ways to be intimate with her husband.
Found sex uncomfortable after her treatment so found other ways to be intimate with her husband.
Age at interview: 50
Sex: Female
Age at diagnosis: 47
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Sexually, yeah, sex isn't easy for me, you know. It hurts actually and so, yeah, the enjoyment of sex isn't as good as it used to be for, you know, me and my partner, me and my husband, you know. We do other things' We can have fun. You know, you can love each other, can't you? Caress each other and, you know, so you might not actually make, have intercourse as often as you used to but we're getting older anyway.
Several women were conscious that it was difficult for their partners to come to terms with an abrupt halt to their sex lives. One woman said that because she did not want any physical contact it would have been easier if she had been single. Others said that their husbands had been afraid of causing damage or pain, and one said that her husband had become temporarily impotent as a result of the different sensations he felt during sex. Despite these difficulties several women said their partners had been understanding and supportive.
Said that her husband had become temporarily impotent because sex felt different to him after her...
Said that her husband had become temporarily impotent because sex felt different to him after her...
Age at interview: 65
Sex: Female
Age at diagnosis: 59
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There is one side effect that is quite embarrassing to talk about but I feel that perhaps it should be noted. It's to do with the sexual side. My husband found that, how he described it as it was empty, and we did find it very difficult, and it maybe that other people perhaps don't know about that side of things and feel perhaps they're the only ones. But there are other ways, but that was a comment that he did say, and it did make him impotent for a couple of years. He's fine now, and as I said, there are other ways, and I find it difficult to talk about but it is something that perhaps people might like to know.
Had been concerned about her body image and about having sex, but her husband had been very...
Had been concerned about her body image and about having sex, but her husband had been very...
Age at interview: 42
Sex: Female
Age at diagnosis: 41
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But no I think initially you're sort of scared of having intercourse because you're scared of something, you know, breaking or going wrong or probably not being exactly the same because you haven't got all your bits there, sort of thing. But I don't, you know, not really had any problems. And I mean my husband is very good about sort of, he doesn't, as long as I'm there he doesn't care what I look like or, you know, sort of having gone through this as long as I'm still here then, you know, he's not bothered. And he's making, you know, he's good at making you feel sort of feminine, you know, the same as I was really. So no, no problems.
Good.
I think the problem is probably more in my head than anything else, you know, but I think as time goes on it gets easier.
Health professionals do not often seem to raise the issue of women's sex lives after treatment - some women thought they should. If the subject is raised couples can be referred to the specialist nurse and then referred on for psychosexual therapy if needed. One woman's GP had offered therapy, but the couple agreed it wasn't much of a problem to them. Another women who thought her husband suffered from the loss of their sexual relationship said she was too private about these things to want to talk to a counsellor.
Health professionals had not talked about sexual issues in relation to her treatment.
Health professionals had not talked about sexual issues in relation to her treatment.
Age at interview: 41
Sex: Female
Age at diagnosis: 35
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Would you be prepared to say if you've had any physical problems in your relationship as a result?
None at all. That wasn't affected in any way whatsoever. But I know it's an area that's not addressed very often. I distinctly remember in the hospital, the doctors asking one seventy-eight year old lady down there if she was still having sexual relations, but they didn't ask me, and they didn't, they didn't cover any psychosexual issues at all. Which is quite a big omission really, because for some people they might not be as fortunate as me and it could be a huge problem, but fortunately it's not been for me.
Some women were able to resume a normal sex life after their treatment, and one woman said that the experience of her illness had actually strengthened her marriage.
Despite initial concerns, had no difficulty resuming a normal sex life after treatment thanks to...
Despite initial concerns, had no difficulty resuming a normal sex life after treatment thanks to...
Age at interview: 33
Sex: Female
Age at diagnosis: 30
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Probably I'm very lucky because I was married for five years before it happened to me, have a very, very loving and supportive husband, so perhaps I'm one of the lucky ones in the respect that he loved me for who I was and didn't mind my scar and everything, and luckily as well, I presume, the actual sex wasn't sore or difficult or anything like that so it made it easier for me and luckily it felt kind of the same. It was just, you know, maybe the first few times was difficult because you had this big scar. But at the end of the day, because I had a loving husband that was prepared to just say 'well, you know, it's only a scar, as long as you're here', whatever.
Had no difficulty resuming a normal sex life after treatment and felt the experience had...
Had no difficulty resuming a normal sex life after treatment and felt the experience had...
Age at interview: 44
Sex: Female
Age at diagnosis: 38
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Well my husband and I had to go through six cycles of IVF. IVF in itself is something which can cause a bit of tension between a couple because you are on an emotional roller coaster during that treatment. And prior to having IVF I think the actual fact of trying for a family and looking at temperatures, times of the month and things like that, that can cause some tension as well between the couple.
However whenever I was diagnosed with cancer obviously that put an end to all of that and after my physical recovery from the hysterectomy my husband and I resumed a very normal and very happy sexual relationship and emotional relationship. And I would say, if anything, having been through the trauma of infertility, of IVF, of being diagnosed with cancer and all the emotions that come with that, and all the fears and anxieties, our relationship has strengthened because we came through it all together.
Last reviewed June 2016.
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