Many transplant survivors have some sexual problems, such as loss of interest in sex, or pain, or sexual dysfunction. For more information about dealing with sexual problems after transplant, see Physical Health and Emotional Health.
Reclaiming your sexuality
Serious illness and its treatment can have a negative impact on sexuality. Not all patients experience difficulty with their sexual relationships. Learning to cope with these changes and find new ways to express your sexuality is an important aspect of your recovery.
Feelings about sexuality may affect:
- Your enthusiasm for living
- Your self-image
- Your relationships with others
As with most of the side effects you may be experiencing, most sexual problems are also variable and can be temporary. Your illness and treatment need not be the end of your sexual life. Help is available.
Some common sexual problems and their solutions
Changes in sex drive, mismatched desire
Fatigue or feeling ill can lead to loss of interest in sex. It is important to let your partner know how you feel so that he or she does not feel rejected. You can also explore alternatives that help you maintain intimacy - such as cuddling or massage. You can also be flexible about times of day, making love when you feel at your best.
Sometimes a person's sex drive increases, especially if intimate touch helps to relieve stress. It's important to acknowledge these changes and talk through them with your partner. You can reduce frustration by accepting and encouraging self stimulation. This can be a useful way for both of you to meet your needs and respect the fact that the mismatch is real and acceptable.
Viagra® and similar drugs can be used to raise both men's and women's sex drive. They may also increase vaginal lubrication leading to reduced pain during sex, more arousal and increased ability to achieve orgasm. Women may sometimes be given male hormones to increase sex drive. Check with your doctor about these options.
Pain during intercourse
Pain can reduce sexual feelings and reduce desire. Fear of pain can lead to tension which inhibits arousal, prevents lubrication and can cause further pain. Talk to your partner about what is painful so that you can explore other positions or ways of making love. Tell your doctor if you have pain. Often the cause can be treated simply. When you're ready, you might experiment with less strenuous activities, such as mutual masturbation, side by side positions, quicker rather than prolonged sexual encounters, etc. Plan to make love after pain medicines have been taken. Use pillows and cushions to get more comfortable. Allow the person who has the pain to control the depth, speed and duration of penetration.
Vaginal dryness
Numerous creams, gels and lubricants can help. Ask your doctor to prescribe or recommend a product that is best for you.
Vaginal narrowing
Vaginal narrowing can be treated with dilators. These are plastic, or glass tubes of varying sizes which can be used with lubricants and inserted by yourself or your partner. The dilators prevent the walls of the vagina from sticking together.
Sores or bleeding
If you have sore areas in your vagina, or any unusual bleeding after intercourse, you need to tell your doctor about this and ask for an examination.
Infection
Changes in the acidity in the vagina can make women prone to vaginal infections. If you notice a creamy-white discharge, or an itchiness in the vaginal area which gets worse if you scratch, then you may have an infection. This is easily treated. If you have had sexual contact, your partner may also need treatment.
Difficulty achieving or maintaining erection
Many men have erection difficulties during their recovery. The cause may be physical or psychological. Talk to your doctor. Some men recover full erections with time. Until then a half-erect penis can still be effective for making love. You might also rely on a wider range of sexual activities for pleasure, including oral sex, masturbation, or use of a vibrator.
There are many options to help you to get an erection. Remember that these will not necessarily increase your feelings of arousal. Your doctor can give more information.
Problems with body image
Changes in body image can cause feelings of distress that go far beyond the physical effects of your treatment and recovery. Sudden and dramatic changes in body image can lead to feelings of shame, embarrassment, inferiority and anger. These feelings can be reinforced by other people's reactions.
It's important for both you and your partner to talk through your fears, rather than hiding them and letting them grow. Together, you can plan on ways to manage fears and help build your confidence.
You might start by making love in a darkened room, partially clothed, or facing away from your partner. Most people find their lovers are much less concerned by their body changes than they imagined.
Open communication can help you feel more relaxed and accepting of body changes.
Partners
You may also find that your partner is afraid to touch you for fear of hurting you. He or she may incorrectly believe that sex with you puts them at risk. Your partner might believe that their desire for sex is selfish or demanding. Your partner may lose desire because of the changes you've undergone. They may feel rejected if they do not realize that your reduction in sexual desire is due to the physical and emotional effects of your treatment. Again, open communication is essential to working through these problems.
Discussing sexual health
Because our sex lives are usually private, talking about this complication might be embarrassing. Remember that most doctors are used to dealing with this subject and should be able to answer your questions. Many hospitals have clinical nurse specialists who can answer any questions that you have. It can be reassuring to discuss any problems that you have in order to find solutions.
You may find it helpful to write down your questions in advance. If you do not want to talk to anyone face to face, you might prefer using a confidential help line.
Remember that everyone is a unique, individual sexual being, and medical professionals are aware of this. You do not need to worry about what is considered "normal." It is more important to focus on your own needs, wishes and desires. As you adjust to the changes you are experiencing, your sexuality might also change. Your goal is to feel good about who you are, and how you choose to share that with others.
Remember: Open, honest communication can improve emotional intimacy even when sexual intercourse is not possible. Managing all the changes in your life can be difficult, but the changes can also help to grow and improve your relationships.
Many people report:
- Increased honesty with their partner
- Greater commitment to trying new things, sexually and otherwise.
- Becoming more assertive about what they want out of life.
- Renewed interest and greater appreciation for all aspects of life.